Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.00 / $63.75 / $97.06	Facility	26	$58.00	$63.75	$97.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.34 / $236.70 / $525.50	Professional		$171.34	$236.70	$525.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $58.24 / $167.18	Professional	26	$52.46	$58.24	$167.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $113.33 / $175.12 / $304.92	Professional	TC	$113.33	$175.12	$304.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.97 / $77.23 / $120.87	Professional	26	$42.97	$77.23	$120.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.22 / $151.22 / $151.22	Professional		$151.22	$151.22	$151.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.55 / $141.43 / $174.80	Professional	26	$95.55	$141.43	$174.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $306.35 / $469.43 / $713.27	Professional	TC	$306.35	$469.43	$713.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.98 / $65.98 / $65.98	Facility	26	$65.98	$65.98	$65.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $226.67 / $422.62 / $725.86	Professional		$226.67	$422.62	$725.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.95 / $94.94 / $166.81	Professional	26	$55.95	$94.94	$166.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.66 / $306.80 / $599.03	Professional	TC	$157.66	$306.80	$599.03
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $88.28 / $100.00 / $184.41	Facility	26	$88.28	$100.00	$184.41
Medcost Facility/Professional Professional Modifier Low / Median / High Price $77.00 / $208.00 / $285.00	Professional		$77.00	$208.00	$285.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $88.28 / $88.28 / $213.48	Professional	26	$88.28	$88.28	$213.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $71.90 / $158.03 / $281.19	Professional		$71.90	$158.03	$281.19
United Facility/Professional Professional Modifier Low / Median / High Price $187.24 / $327.67 / $564.57	Professional		$187.24	$327.67	$564.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.77 / $79.06 / $160.66	Professional	26	$58.77	$79.06	$160.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.78 / $255.79 / $437.54	Professional	TC	$134.78	$255.79	$437.54
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $417.20 / $525.76 / $525.76	Facility	26	$417.20	$525.76	$525.76
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,938.85 / $1,938.85 / $1,938.85	Professional		$1,938.85	$1,938.85	$1,938.85
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $434.24 / $434.24 / $459.75	Professional	26	$434.24	$434.24	$459.75
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,624.23 / $1,624.23 / $1,624.23	Professional	TC	$1,624.23	$1,624.23	$1,624.23