Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.00 / $66.54 / $97.45	Facility	26	$58.00	$66.54	$97.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.34 / $275.00 / $699.30	Professional		$171.34	$275.00	$699.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $58.61 / $169.44	Professional	26	$52.78	$58.61	$169.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $113.33 / $174.75 / $304.00	Professional	TC	$113.33	$174.75	$304.00
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 $152.68 / $152.68 / $152.68	Professional		$152.68	$152.68	$152.68
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.55 / $142.79 / $174.80	Professional	26	$95.55	$142.79	$174.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $306.35 / $439.04 / $713.27	Professional	TC	$306.35	$439.04	$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 $234.47 / $423.13 / $725.07	Professional		$234.47	$423.13	$725.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.95 / $95.46 / $166.81	Professional	26	$55.95	$95.46	$166.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.10 / $307.41 / $598.24	Professional	TC	$158.10	$307.41	$598.24
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $88.28 / $101.00 / $182.00	Facility	26	$88.28	$101.00	$182.00
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 / $158.47 / $282.24	Professional		$71.90	$158.47	$282.24
United Facility/Professional Professional Modifier Low / Median / High Price $196.96 / $327.17 / $569.09	Professional		$196.96	$327.17	$569.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.77 / $78.59 / $162.34	Professional	26	$58.77	$78.59	$162.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $135.16 / $245.54 / $435.01	Professional	TC	$135.16	$245.54	$435.01
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 $1,906.00 / $1,906.00 / $1,906.00	Professional	TC	$1,906.00	$1,906.00	$1,906.00