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 $131.03 / $221.75 / $689.27	Professional		$131.03	$221.75	$689.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.99 / $51.59 / $146.44	Professional	26	$43.99	$51.59	$146.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.45 / $136.80 / $253.10	Professional	TC	$83.45	$136.80	$253.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.07 / $129.58 / $325.92	Professional		$98.07	$129.58	$325.92
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 $58.80 / $161.88 / $161.88	Professional	TC	$58.80	$161.88	$161.88
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 / $353.26 / $498.81	Professional	TC	$231.08	$353.26	$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 $179.75 / $346.34 / $609.97	Professional		$179.75	$346.34	$609.97
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 $116.58 / $243.70 / $489.00	Professional	TC	$116.58	$243.70	$489.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $83.58 / $96.00 / $169.42	Facility	26	$83.58	$96.00	$169.42
Medcost Facility/Professional Professional Modifier Low / Median / High Price $64.00 / $161.00 / $225.00	Professional		$64.00	$161.00	$225.00
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 / $116.76 / $216.07	Professional		$58.87	$116.76	$216.07
United Facility/Professional Professional Modifier Low / Median / High Price $155.91 / $273.57 / $474.43	Professional		$155.91	$273.57	$474.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.45 / $68.29 / $134.94	Professional	26	$49.45	$68.29	$134.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.72 / $190.34 / $339.35	Professional	TC	$98.72	$190.34	$339.35
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