Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.57 / $59.18 / $83.00	Facility	26	$47.57	$59.18	$83.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.42 / $161.99 / $401.77	Professional		$59.42	$161.99	$401.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $55.00 / $213.54	Professional	26	$43.82	$55.00	$213.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.99 / $43.99 / $43.99	Professional	50	$43.99	$43.99	$43.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $103.05 / $169.99 / $368.03	Professional	TC	$103.05	$169.99	$368.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.32 / $284.74 / $370.80	Professional		$121.32	$284.74	$370.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.19 / $72.58 / $149.88	Professional	26	$35.19	$72.58	$149.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $161.88 / $161.88 / $161.88	Professional	TC	$161.88	$161.88	$161.88
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 $85.45 / $119.66 / $145.84	Professional	26	$85.45	$119.66	$145.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $235.90 / $339.80 / $494.51	Professional	TC	$235.90	$339.80	$494.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.56 / $335.67 / $562.03	Professional		$208.56	$335.67	$562.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.03 / $80.20 / $138.61	Professional	26	$50.03	$80.20	$138.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $149.28 / $250.99 / $447.78	Professional	TC	$149.28	$250.99	$447.78
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $78.59 / $90.00 / $148.00	Facility	26	$78.59	$90.00	$148.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $64.00 / $161.00 / $225.00	Professional		$64.00	$161.00	$225.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $78.59 / $78.59 / $175.09	Professional	26	$78.59	$78.59	$175.09
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $505.92 / $505.92 / $831.48	Professional	50	$505.92	$505.92	$831.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.87 / $145.12 / $291.50	Professional		$58.87	$145.12	$291.50
United Facility/Professional Professional Modifier Low / Median / High Price $170.98 / $274.20 / $476.73	Professional		$170.98	$274.20	$476.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.69 / $68.84 / $134.94	Professional	26	$49.69	$68.84	$134.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $121.11 / $203.67 / $345.37	Professional	TC	$121.11	$203.67	$345.37
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $341.52 / $430.56 / $430.56	Facility	26	$341.52	$430.56	$430.56
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,420.14 / $1,420.14 / $1,420.14	Professional		$1,420.14	$1,420.14	$1,420.14
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $300.10 / $300.10 / $376.28	Professional	26	$300.10	$300.10	$376.28
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,137.09 / $1,137.09 / $1,137.09	Professional	TC	$1,137.09	$1,137.09	$1,137.09