Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $95.50 / $218.78	Facility	26	$70.79	$95.50	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $478.63 / $1,230.27	Professional		$194.98	$478.63	$1,230.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $138.04 / $288.40	Professional	26	$64.57	$138.04	$288.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $269.15 / $616.60	Professional	TC	$123.03	$269.15	$616.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $154.88 / $194.98	Professional		$72.44	$154.88	$194.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $70.79 / $141.25	Professional	26	$52.48	$70.79	$141.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $112.20 / $186.21	Professional	TC	$63.10	$112.20	$186.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $181.97 / $218.78	Professional	26	$123.03	$181.97	$218.78
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $630.96 / $891.25	Professional	TC	$371.54	$630.96	$891.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $114.82	Facility	26	$16.98	$79.43	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $512.86 / $1,000.00	Professional		$229.09	$512.86	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $112.20 / $204.17	Professional	26	$63.10	$112.20	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $346.74 / $812.83	Professional	TC	$141.25	$346.74	$812.83
Medcost Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $870.96	Professional		$870.96	$870.96	$870.96
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Professional	26	$141.25	$141.25	$141.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Professional		$446.68	$446.68	$446.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $177.83 / $380.19	Professional		$70.79	$177.83	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $398.11 / $691.83	Professional		$208.93	$398.11	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $91.20 / $181.97	Professional	26	$70.79	$91.20	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $257.04 / $562.34	Professional	TC	$134.90	$257.04	$562.34
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $645.65 / $645.65 / $645.65	Facility	26	$645.65	$645.65	$645.65
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,235.94 / $3,235.94 / $3,235.94	Professional		$3,235.94	$3,235.94	$3,235.94
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $602.56 / $602.56 / $602.56	Professional	26	$602.56	$602.56	$602.56
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,884.03 / $2,884.03 / $2,884.03	Professional	TC	$2,884.03	$2,884.03	$2,884.03