Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.00 / $66.18 / $97.45	Facility	26	$58.00	$66.18	$97.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $227.18 / $275.00 / $622.66	Professional		$227.18	$275.00	$622.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.41 / $58.01 / $128.82	Professional	26	$51.41	$58.01	$128.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.17 / $208.25 / $418.28	Professional	TC	$169.17	$208.25	$418.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $188.20 / $188.20 / $188.20	Professional		$188.20	$188.20	$188.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.26 / $58.01 / $107.44	Professional	26	$42.26	$58.01	$107.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.10 / $152.10 / $152.10	Professional		$152.10	$152.10	$152.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.55 / $129.44 / $174.80	Professional	26	$95.55	$129.44	$174.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $406.82 / $534.82 / $838.39	Professional	TC	$406.82	$534.82	$838.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.64 / $65.64 / $65.64	Facility	26	$65.64	$65.64	$65.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.95 / $511.94 / $880.69	Professional		$301.95	$511.94	$880.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.66 / $94.94 / $166.81	Professional	26	$55.66	$94.94	$166.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $233.94 / $412.19 / $743.07	Professional	TC	$233.94	$412.19	$743.07
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $87.93 / $118.00 / $180.48	Facility	26	$87.93	$118.00	$180.48
Medcost Facility/Professional Professional Modifier Low / Median / High Price $77.00 / $247.00 / $333.00	Professional		$77.00	$247.00	$333.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $87.93 / $87.93 / $118.00	Professional	26	$87.93	$87.93	$118.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $622.54 / $622.54 / $622.54	Professional	TC	$622.54	$622.54	$622.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.58 / $231.04 / $449.70	Professional		$58.58	$231.04	$449.70
United Facility/Professional Professional Modifier Low / Median / High Price $259.68 / $405.95 / $715.25	Professional		$259.68	$405.95	$715.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.77 / $79.58 / $162.34	Professional	26	$58.77	$79.58	$162.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $198.91 / $328.35 / $558.24	Professional	TC	$198.91	$328.35	$558.24
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $417.20 / $525.76 / $525.76	Facility	26	$417.20	$525.76	$525.76
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,261.56 / $2,261.56 / $2,261.56	Professional		$2,261.56	$2,261.56	$2,261.56
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $439.20 / $439.20 / $459.75	Professional	26	$439.20	$439.20	$459.75
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,946.93 / $1,946.93 / $1,946.93	Professional	TC	$1,946.93	$1,946.93	$1,946.93