Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.57 / $63.06 / $83.00	Facility	26	$47.57	$63.06	$83.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.37 / $220.22 / $619.23	Professional		$131.37	$220.22	$619.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $51.59 / $137.69	Professional	26	$44.14	$51.59	$137.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.78 / $147.21 / $252.76	Professional	TC	$83.78	$147.21	$252.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.32 / $98.32 / $98.32	Professional		$98.32	$98.32	$98.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.19 / $72.58 / $98.98	Professional	26	$35.19	$72.58	$98.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $163.24 / $163.24 / $163.24	Professional	TC	$163.24	$163.24	$163.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.77 / $144.77 / $144.77	Professional		$144.77	$144.77	$144.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.86 / $125.37 / $153.75	Professional	26	$88.86	$125.37	$153.75
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $231.08 / $331.77 / $498.81	Professional	TC	$231.08	$331.77	$498.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $180.20 / $336.99 / $610.76	Professional		$180.20	$336.99	$610.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.87 / $84.06 / $138.61	Professional	26	$51.87	$84.06	$138.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.38 / $244.61 / $489.79	Professional	TC	$117.38	$244.61	$489.79
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $83.78 / $95.00 / $157.50	Facility	26	$83.78	$95.00	$157.50
Medcost Facility/Professional Professional Modifier Low / Median / High Price $64.00 / $162.00 / $226.00	Professional		$64.00	$162.00	$226.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $83.78 / $83.78 / $175.09	Professional	26	$83.78	$83.78	$175.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.87 / $117.50 / $216.59	Professional		$58.87	$117.50	$216.59
United Facility/Professional Professional Modifier Low / Median / High Price $156.18 / $275.81 / $475.04	Professional		$156.18	$275.81	$475.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.45 / $69.91 / $134.94	Professional	26	$49.45	$69.91	$134.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.62 / $195.91 / $342.65	Professional	TC	$103.62	$195.91	$342.65
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $341.52 / $430.56 / $430.56	Facility	26	$341.52	$430.56	$430.56
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,657.60 / $1,657.60 / $1,657.60	Professional		$1,657.60	$1,657.60	$1,657.60
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $379.76 / $379.76 / $379.76	Professional	26	$379.76	$379.76	$379.76
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,357.90 / $1,357.90 / $1,357.90	Professional	TC	$1,357.90	$1,357.90	$1,357.90