Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.65 / $59.54 / $85.23	Facility	26	$51.65	$59.54	$85.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.80 / $220.65 / $693.07	Professional		$134.80	$220.65	$693.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.01 / $54.56 / $154.69	Professional	26	$48.01	$54.56	$154.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.14 / $145.74 / $245.43	Professional	TC	$83.14	$145.74	$245.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $101.03	Professional		$101.03	$101.03	$101.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.47 / $79.22 / $108.02	Professional	26	$38.47	$79.22	$108.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $61.62 / $61.62 / $61.62	Professional	TC	$61.62	$61.62	$61.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.50 / $136.50 / $136.50	Professional		$136.50	$136.50	$136.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.06 / $121.64 / $157.44	Professional	26	$86.06	$121.64	$157.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.95 / $303.06 / $498.50	Professional	TC	$223.95	$303.06	$498.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.04 / $59.04 / $59.04	Facility	26	$59.04	$59.04	$59.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.74 / $329.25 / $592.55	Professional		$165.74	$329.25	$592.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.03 / $84.54 / $149.58	Professional	26	$50.03	$84.54	$149.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.02 / $219.46 / $471.40	Professional	TC	$104.02	$219.46	$471.40
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $115.65 / $165.00	Facility	26	$79.09	$115.65	$165.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $69.00 / $114.00 / $225.00	Professional		$69.00	$114.00	$225.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $79.09 / $79.09 / $190.11	Professional	26	$79.09	$79.09	$190.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $52.67 / $122.75 / $288.20	Professional		$52.67	$122.75	$288.20
United Facility/Professional Professional Modifier Low / Median / High Price $139.65 / $263.43 / $417.54	Professional		$139.65	$263.43	$417.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.59 / $70.47 / $146.47	Professional	26	$52.59	$70.47	$146.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.52 / $165.65 / $272.35	Professional	TC	$85.52	$165.65	$272.35
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $373.44 / $470.00 / $470.00	Facility	26	$373.44	$470.00	$470.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,640.91 / $1,640.91 / $1,640.91	Professional		$1,640.91	$1,640.91	$1,640.91
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $325.83 / $325.83 / $412.05	Professional	26	$325.83	$325.83	$412.05
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,357.90 / $1,357.90 / $1,357.90	Professional	TC	$1,357.90	$1,357.90	$1,357.90