Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $117.49 / $338.84	Facility	26	$85.11	$117.49	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $446.68 / $1,148.15	Professional		$275.42	$446.68	$1,148.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $141.25 / $338.84	Professional	26	$83.18	$141.25	$338.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $316.23 / $707.95	Professional	TC	$190.55	$316.23	$707.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $77.62 / $177.83	Professional	26	$75.86	$77.62	$177.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $134.90 / $134.90	Professional	TC	$134.90	$134.90	$134.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $204.17 / $257.04	Professional	26	$138.04	$204.17	$257.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $660.69 / $1,023.29	Professional	TC	$489.78	$660.69	$1,023.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $138.04	Facility	26	$20.89	$97.72	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $660.69 / $1,202.26	Professional		$309.03	$660.69	$1,202.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $128.82 / $239.88	Professional	26	$74.13	$128.82	$239.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $489.78 / $977.24	Professional	TC	$218.78	$489.78	$977.24
Medcost Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $954.99 / $954.99	Professional		$954.99	$954.99	$954.99
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Professional	26	$158.49	$158.49	$158.49
Medcost Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Professional		$549.54	$549.54	$549.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $251.19 / $549.54	Professional		$85.11	$251.19	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $524.81 / $851.14	Professional		$295.12	$524.81	$851.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $104.71 / $218.78	Professional	26	$81.28	$104.71	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $389.05 / $676.08	Professional	TC	$208.93	$389.05	$676.08
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $776.25 / $776.25 / $776.25	Facility	26	$776.25	$776.25	$776.25
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $3,548.13 / $3,548.13	Professional		$3,548.13	$3,548.13	$3,548.13
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $660.69 / $660.69 / $691.83	Professional	26	$660.69	$660.69	$691.83
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $3,090.30 / $3,090.30 / $3,090.30	Professional	TC	$3,090.30	$3,090.30	$3,090.30