Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.01 / $93.43 / $142.24	Facility	26	$85.01	$93.43	$142.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.77 / $425.00 / $751.02	Professional		$282.77	$425.00	$751.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.02 / $118.49 / $210.68	Professional	26	$85.02	$118.49	$210.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $197.75 / $282.87 / $489.07	Professional	TC	$197.75	$282.87	$489.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $558.84 / $558.84 / $558.84	Professional		$558.84	$558.84	$558.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $159.00 / $178.88 / $178.88	Professional	26	$159.00	$178.88	$178.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $242.05 / $242.05 / $242.05	Professional		$242.05	$242.05	$242.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $151.50 / $226.84 / $272.88	Professional	26	$151.50	$226.84	$272.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $435.72 / $755.52 / $1,033.11	Professional	TC	$435.72	$755.52	$1,033.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.16 / $97.16 / $97.16	Facility	26	$97.16	$97.16	$97.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $365.21 / $706.26 / $1,420.98	Professional		$365.21	$706.26	$1,420.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.05 / $145.38 / $250.70	Professional	26	$88.05	$145.38	$250.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $253.47 / $536.92 / $1,163.35	Professional	TC	$253.47	$536.92	$1,163.35
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $138.65 / $159.00 / $263.11	Facility	26	$138.65	$159.00	$263.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $113.00 / $293.00 / $550.00	Professional		$113.00	$293.00	$550.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $138.65 / $138.65 / $159.00	Professional	26	$138.65	$138.65	$159.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $727.72 / $727.72 / $727.72	Professional	TC	$727.72	$727.72	$727.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $88.10 / $281.41 / $467.21	Professional		$88.10	$281.41	$467.21
United Facility/Professional Professional Modifier Low / Median / High Price $304.45 / $573.52 / $924.15	Professional		$304.45	$573.52	$924.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.07 / $123.52 / $245.27	Professional	26	$89.07	$123.52	$245.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.98 / $445.99 / $677.66	Professional	TC	$218.98	$445.99	$677.66
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $620.48 / $778.96 / $778.96	Facility	26	$620.48	$778.96	$778.96
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,587.02 / $3,587.02 / $3,587.02	Professional		$3,587.02	$3,587.02	$3,587.02
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $642.27 / $642.27 / $686.78	Professional	26	$642.27	$642.27	$686.78
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $3,086.80 / $3,086.80 / $3,086.80	Professional	TC	$3,086.80	$3,086.80	$3,086.80