Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.81 / $81.67 / $126.00	Facility	26	$70.81	$81.67	$126.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $196.00 / $425.00 / $1,234.34	Professional		$196.00	$425.00	$1,234.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.13 / $119.21 / $271.00	Professional	26	$69.13	$119.21	$271.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $98.00 / $125.00 / $316.77	Professional	52	$98.00	$125.00	$316.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.17 / $281.41 / $491.04	Professional	TC	$125.17	$281.41	$491.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $167.98 / $309.94 / $995.54	Professional		$167.98	$309.94	$995.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.44 / $94.04 / $147.49	Professional	26	$52.44	$94.04	$147.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $89.24 / $175.03 / $185.34	Professional	TC	$89.24	$175.03	$185.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.35 / $185.35 / $185.35	Professional		$185.35	$185.35	$185.35
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $116.58 / $171.14 / $213.29	Professional	26	$116.58	$171.14	$213.29
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $398.29 / $616.75 / $892.61	Professional	TC	$398.29	$616.75	$892.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.59 / $80.59 / $80.59	Facility	26	$80.59	$80.59	$80.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $256.76 / $556.91 / $1,156.14	Professional		$256.76	$556.91	$1,156.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.25 / $115.90 / $207.30	Professional	26	$68.25	$115.90	$207.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $159.80 / $382.88 / $990.33	Professional	TC	$159.80	$382.88	$990.33
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $106.80 / $153.66 / $235.00	Facility	26	$106.80	$153.66	$235.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $185.00 / $450.00	Professional		$95.00	$185.00	$450.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $106.80 / $106.80 / $260.64	Professional	26	$106.80	$106.80	$260.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.36 / $183.45 / $328.24	Professional		$72.36	$183.45	$328.24
United Facility/Professional Professional Modifier Low / Median / High Price $209.50 / $419.65 / $667.41	Professional		$209.50	$419.65	$667.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.61 / $100.74 / $205.70	Professional	26	$71.61	$100.74	$205.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $137.47 / $268.94 / $563.30	Professional	TC	$137.47	$268.94	$563.30
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $510.16 / $641.91 / $641.91	Facility	26	$510.16	$641.91	$641.91
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,240.21 / $3,240.21 / $3,240.21	Professional		$3,240.21	$3,240.21	$3,240.21
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $577.89 / $577.89 / $577.89	Professional	26	$577.89	$577.89	$577.89
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,855.17 / $2,855.17 / $2,855.17	Professional	TC	$2,855.17	$2,855.17	$2,855.17