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 / $196.86	Facility	26	$108.70	$126.00	$196.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.93 / $474.35 / $1,676.88	Professional		$328.93	$474.35	$1,676.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.85 / $145.65 / $421.32	Professional	26	$103.85	$145.65	$421.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.23 / $335.00 / $709.46	Professional	TC	$220.23	$335.00	$709.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $243.15 / $815.34 / $815.34	Professional		$243.15	$815.34	$815.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.62 / $167.85 / $274.80	Professional	26	$81.62	$167.85	$274.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $333.23 / $333.23 / $333.23	Professional	TC	$333.23	$333.23	$333.23
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 / $299.08 / $341.23	Professional	26	$200.80	$299.08	$341.23
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $629.95 / $1,103.00 / $1,474.43	Professional	TC	$629.95	$1,103.00	$1,474.43
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 $430.76 / $943.57 / $1,855.84	Professional		$430.76	$943.57	$1,855.84
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 $287.33 / $664.55 / $1,623.01	Professional	TC	$287.33	$664.55	$1,623.01
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $183.65 / $212.00 / $362.75	Facility	26	$183.65	$212.00	$362.75
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 / $319.75 / $544.35	Professional		$111.82	$319.75	$544.35
United Facility/Professional Professional Modifier Low / Median / High Price $353.03 / $684.54 / $1,152.32	Professional		$353.03	$684.54	$1,152.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $114.18 / $151.52 / $314.00	Professional	26	$114.18	$151.52	$314.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.11 / $460.98 / $949.16	Professional	TC	$244.11	$460.98	$949.16
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 $6,381.10 / $6,381.10 / $6,381.10	Professional		$6,381.10	$6,381.10	$6,381.10
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