Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.33 / $66.54 / $97.58	Facility	26	$58.33	$66.54	$97.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.62 / $275.00 / $741.76	Professional		$172.62	$275.00	$741.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $59.45 / $169.37	Professional	26	$52.78	$59.45	$169.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.29 / $175.49 / $312.83	Professional	TC	$114.29	$175.49	$312.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.15 / $77.23 / $145.63	Professional	26	$43.15	$77.23	$145.63
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 $96.14 / $143.80 / $175.89	Professional	26	$96.14	$143.80	$175.89
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $306.35 / $440.48 / $713.27	Professional	TC	$306.35	$440.48	$713.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.34 / $66.34 / $66.34	Facility	26	$66.34	$66.34	$66.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.86 / $423.13 / $726.65	Professional		$228.86	$423.13	$726.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.95 / $95.46 / $166.88	Professional	26	$55.95	$95.46	$166.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $159.00 / $307.41 / $599.03	Professional	TC	$159.00	$307.41	$599.03
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $88.28 / $100.00 / $181.47	Facility	26	$88.28	$100.00	$181.47
Medcost Facility/Professional Professional Modifier Low / Median / High Price $78.00 / $209.00 / $287.00	Professional		$78.00	$209.00	$287.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $88.28 / $88.28 / $214.65	Professional	26	$88.28	$88.28	$214.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.33 / $159.38 / $284.33	Professional		$72.33	$159.38	$284.33
United Facility/Professional Professional Modifier Low / Median / High Price $196.09 / $339.11 / $572.08	Professional		$196.09	$339.11	$572.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.77 / $79.39 / $163.32	Professional	26	$58.77	$79.39	$163.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $133.37 / $247.50 / $438.09	Professional	TC	$133.37	$247.50	$438.09
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $419.92 / $528.08 / $528.08	Facility	26	$419.92	$528.08	$528.08
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,941.31 / $1,941.31 / $1,941.31	Professional		$1,941.31	$1,941.31	$1,941.31
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $434.24 / $434.24 / $463.80	Professional	26	$434.24	$434.24	$463.80
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,950.00 / $1,950.00 / $1,950.00	Professional	TC	$1,950.00	$1,950.00	$1,950.00