Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.34 / $123.27 / $180.14	Facility	26	$104.34	$123.27	$180.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.94 / $475.00 / $1,760.66	Professional		$347.94	$475.00	$1,760.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.40 / $140.00 / $348.00	Professional	26	$99.40	$140.00	$348.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $243.60 / $335.00 / $889.00	Professional	TC	$243.60	$335.00	$889.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $127.27 / $858.18 / $858.18	Professional		$127.27	$858.18	$858.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.93 / $111.56 / $219.17	Professional	26	$77.93	$111.56	$219.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $493.84 / $493.84 / $493.84	Professional	TC	$493.84	$493.84	$493.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.02 / $281.02 / $281.02	Professional		$281.02	$281.02	$281.02
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $173.12 / $256.22 / $319.31	Professional	26	$173.12	$256.22	$319.31
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $634.05 / $1,059.99 / $1,484.05	Professional	TC	$634.05	$1,059.99	$1,484.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $455.80 / $1,025.06 / $1,892.19	Professional		$455.80	$1,025.06	$1,892.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.40 / $175.72 / $306.58	Professional	26	$103.40	$175.72	$306.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $324.63 / $817.59 / $1,650.54	Professional	TC	$324.63	$817.59	$1,650.54
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $162.88 / $185.00 / $321.67	Facility	26	$162.88	$185.00	$321.67
Medcost Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $488.00 / $750.00	Professional		$144.00	$488.00	$750.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $185.00 / $383.97 / $383.97	Professional	26	$185.00	$383.97	$383.97
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $742.85 / $742.85 / $742.85	Professional	TC	$742.85	$742.85	$742.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $130.80 / $314.98 / $562.24	Professional		$130.80	$314.98	$562.24
United Facility/Professional Professional Modifier Low / Median / High Price $381.32 / $739.77 / $1,370.65	Professional		$381.32	$739.77	$1,370.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $106.27 / $145.47 / $299.86	Professional	26	$106.27	$145.47	$299.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $281.29 / $561.94 / $1,133.09	Professional	TC	$281.29	$561.94	$1,133.09
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $759.68 / $954.08 / $954.08	Facility	26	$759.68	$954.08	$954.08
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $6,206.15 / $6,206.15 / $6,206.15	Professional		$6,206.15	$6,206.15	$6,206.15
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $891.52 / $891.52 / $891.52	Professional	26	$891.52	$891.52	$891.52
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $5,621.63 / $5,621.63 / $5,621.63	Professional	TC	$5,621.63	$5,621.63	$5,621.63