Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $85.10 / $143.84	Facility	26	$83.00	$85.10	$143.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.59 / $275.00 / $695.72	Professional		$254.59	$275.00	$695.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.83 / $85.10 / $247.19	Professional	26	$66.83	$85.10	$247.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.49 / $212.66 / $385.85	Professional	TC	$169.49	$212.66	$385.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.91 / $172.26 / $178.36	Professional	26	$67.91	$172.26	$178.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.12 / $225.12 / $225.12	Professional		$225.12	$225.12	$225.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $139.58 / $211.32 / $261.12	Professional	26	$139.58	$211.32	$261.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $444.34 / $642.20 / $859.49	Professional	TC	$444.34	$642.20	$859.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.97 / $96.97 / $96.97	Facility	26	$96.97	$96.97	$96.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $386.97 / $651.74 / $1,110.08	Professional		$386.97	$651.74	$1,110.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.40 / $141.87 / $246.94	Professional	26	$83.40	$141.87	$246.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $271.35 / $495.85 / $894.94	Professional	TC	$271.35	$495.85	$894.94
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $131.69 / $149.00 / $245.74	Facility	26	$131.69	$149.00	$245.74
Medcost Facility/Professional Professional Modifier Low / Median / High Price $115.00 / $268.00 / $382.00	Professional		$115.00	$268.00	$382.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $131.69 / $131.69 / $149.00	Professional	26	$131.69	$131.69	$149.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $623.72 / $623.72 / $623.72	Professional	TC	$623.72	$623.72	$623.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $86.29 / $280.69 / $541.40	Professional		$86.29	$280.69	$541.40
United Facility/Professional Professional Modifier Low / Median / High Price $308.64 / $540.12 / $967.85	Professional		$308.64	$540.12	$967.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.09 / $117.06 / $243.14	Professional	26	$87.09	$117.06	$243.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $219.38 / $416.82 / $674.42	Professional	TC	$219.38	$416.82	$674.42
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $618.08 / $776.08 / $776.08	Facility	26	$618.08	$776.08	$776.08
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,174.35 / $3,174.35 / $3,174.35	Professional		$3,174.35	$3,174.35	$3,174.35
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $554.78 / $554.78 / $683.18	Professional	26	$554.78	$554.78	$683.18
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,704.69 / $2,704.69 / $2,704.69	Professional	TC	$2,704.69	$2,704.69	$2,704.69