Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.67 / $66.34 / $100.99	Facility	26	$60.67	$66.34	$100.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.93 / $240.82 / $406.55	Professional		$200.93	$240.82	$406.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.83 / $60.67 / $170.68	Professional	26	$53.83	$60.67	$170.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.27 / $168.52 / $325.76	Professional	TC	$140.27	$168.52	$325.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $71.68 / $92.15 / $92.15	Professional	26	$71.68	$92.15	$92.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $159.08 / $159.08 / $159.08	Professional		$159.08	$159.08	$159.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.38 / $131.15 / $183.64	Professional	26	$100.38	$131.15	$183.64
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $370.65 / $622.62 / $837.76	Professional	TC	$370.65	$622.62	$837.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $68.70	Facility	26	$68.70	$68.70	$68.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.30 / $502.33 / $887.43	Professional		$272.30	$502.33	$887.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.33 / $98.70 / $172.86	Professional	26	$58.33	$98.70	$172.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $195.31 / $384.92 / $754.19	Professional	TC	$195.31	$384.92	$754.19
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $91.91 / $105.00 / $204.36	Facility	26	$91.91	$105.00	$204.36
Medcost Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $256.00 / $337.00	Professional		$80.00	$256.00	$337.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $91.91 / $91.91 / $223.27	Professional	26	$91.91	$91.91	$223.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $74.88 / $185.17 / $325.00	Professional		$74.88	$185.17	$325.00
United Facility/Professional Professional Modifier Low / Median / High Price $225.80 / $397.25 / $692.30	Professional		$225.80	$397.25	$692.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.32 / $88.19 / $170.24	Professional	26	$61.32	$88.19	$170.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $156.34 / $318.62 / $545.71	Professional	TC	$156.34	$318.62	$545.71
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $434.48 / $546.72 / $546.72	Facility	26	$434.48	$546.72	$546.72
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,362.66 / $2,362.66 / $2,362.66	Professional		$2,362.66	$2,362.66	$2,362.66
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $523.40 / $523.40 / $523.40	Professional	26	$523.40	$523.40	$523.40
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,412.00 / $2,412.00 / $2,412.00	Professional	TC	$2,412.00	$2,412.00	$2,412.00