Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.70 / $126.00 / $196.31	Facility	26	$108.70	$126.00	$196.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.61 / $475.00 / $1,676.88	Professional		$328.61	$475.00	$1,676.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.70 / $154.82 / $402.43	Professional	26	$108.70	$154.82	$402.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $219.91 / $335.00 / $783.89	Professional	TC	$219.91	$335.00	$783.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $242.66 / $517.77 / $813.73	Professional		$242.66	$517.77	$813.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.38 / $121.04 / $274.80	Professional	26	$81.38	$121.04	$274.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $166.39 / $271.80 / $332.79	Professional	TC	$166.39	$271.80	$332.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $321.25 / $321.25 / $321.25	Professional		$321.25	$321.25	$321.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $200.80 / $300.52 / $341.23	Professional	26	$200.80	$300.52	$341.23
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $630.39 / $1,036.04 / $1,475.46	Professional	TC	$630.39	$1,036.04	$1,475.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $124.22	Facility	26	$124.22	$124.22	$124.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $430.37 / $967.56 / $1,900.93	Professional		$430.37	$967.56	$1,900.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.61 / $189.19 / $320.08	Professional	26	$117.61	$189.19	$320.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $286.95 / $662.72 / $1,632.13	Professional	TC	$286.95	$662.72	$1,632.13
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $185.39 / $249.00 / $336.83	Facility	26	$185.39	$249.00	$336.83
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.00 / $330.00 / $700.00	Professional		$145.00	$330.00	$700.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $185.39 / $185.39 / $400.02	Professional	26	$185.39	$185.39	$400.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $111.82 / $318.77 / $543.25	Professional		$111.82	$318.77	$543.25
United Facility/Professional Professional Modifier Low / Median / High Price $352.35 / $706.22 / $1,169.65	Professional		$352.35	$706.22	$1,169.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $113.63 / $160.06 / $318.17	Professional	26	$113.63	$160.06	$318.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $238.88 / $482.90 / $973.15	Professional	TC	$238.88	$482.90	$973.15
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $794.00 / $996.56 / $996.56	Facility	26	$794.00	$996.56	$996.56
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $6,385.74 / $6,385.74 / $6,385.74	Professional		$6,385.74	$6,385.74	$6,385.74
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $931.20 / $931.20 / $931.20	Professional	26	$931.20	$931.20	$931.20
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $5,717.71 / $5,717.71 / $5,717.71	Professional	TC	$5,717.71	$5,717.71	$5,717.71