Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $100.00 / $239.88	Facility	26	$60.26	$100.00	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $275.42 / $724.44	Professional		$186.21	$275.42	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $64.57 / $177.83	Professional	26	$51.29	$64.57	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $199.53 / $549.54	Professional	TC	$134.90	$199.53	$549.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $54.95 / $63.10	Professional	26	$44.67	$54.95	$63.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $131.83 / $186.21	Professional	26	$97.72	$131.83	$186.21
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $616.60 / $851.14	Professional	TC	$354.81	$616.60	$851.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $97.72	Facility	26	$14.45	$67.61	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $489.78 / $776.25	Professional		$239.88	$489.78	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $91.20 / $169.82	Professional	26	$53.70	$91.20	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $371.54 / $645.65	Professional	TC	$169.82	$371.54	$645.65
Medcost Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Professional		$630.96	$630.96	$630.96
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $112.20 / $112.20	Professional	26	$112.20	$112.20	$112.20
Medcost Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Professional		$275.42	$275.42	$275.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $181.97 / $389.05	Professional		$60.26	$181.97	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $371.54 / $630.96	Professional		$218.78	$371.54	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $75.86 / $144.54	Professional	26	$57.54	$75.86	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $288.40 / $478.63	Professional	TC	$158.49	$288.40	$478.63
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $549.54 / $549.54 / $549.54	Facility	26	$549.54	$549.54	$549.54
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,344.23	Professional		$2,344.23	$2,344.23	$2,344.23
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $524.81 / $524.81 / $524.81	Professional	26	$524.81	$524.81	$524.81
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,398.83 / $2,398.83 / $2,398.83	Professional	TC	$2,398.83	$2,398.83	$2,398.83