Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.72 / $63.47 / $92.54	Facility	26	$54.72	$63.47	$92.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $223.52 / $511.44	Professional		$171.00	$223.52	$511.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $55.59 / $163.68	Professional	26	$50.07	$55.59	$163.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $149.94 / $178.14 / $371.99	Professional	TC	$149.94	$178.14	$371.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $385.32 / $385.32 / $385.32	Professional		$385.32	$385.32	$385.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.94 / $84.45 / $173.97	Professional	26	$40.94	$84.45	$173.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.77 / $144.77 / $144.77	Professional		$144.77	$144.77	$144.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.12 / $136.74 / $166.71	Professional	26	$91.12	$136.74	$166.71
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $323.81 / $459.64 / $688.68	Professional	TC	$323.81	$459.64	$688.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.89 / $62.89 / $62.89	Facility	26	$62.89	$62.89	$62.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.82 / $403.16 / $680.91	Professional		$240.82	$403.16	$680.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.32 / $90.64 / $158.34	Professional	26	$53.32	$90.64	$158.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $188.60 / $303.69 / $547.53	Professional	TC	$188.60	$303.69	$547.53
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $83.78 / $96.00 / $170.10	Facility	26	$83.78	$96.00	$170.10
Medcost Facility/Professional Professional Modifier Low / Median / High Price $74.00 / $204.00 / $281.00	Professional		$74.00	$204.00	$281.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $83.78 / $83.78 / $201.41	Professional	26	$83.78	$83.78	$201.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.54 / $202.84 / $355.90	Professional		$68.54	$202.84	$355.90
United Facility/Professional Professional Modifier Low / Median / High Price $212.91 / $340.88 / $587.39	Professional		$212.91	$340.88	$587.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.68 / $76.52 / $156.03	Professional	26	$55.68	$76.52	$156.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $155.00 / $249.06 / $431.12	Professional	TC	$155.00	$249.06	$431.12
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $397.76 / $501.04 / $501.04	Facility	26	$397.76	$501.04	$501.04
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,657.60 / $1,657.60 / $1,699.73	Professional		$1,657.60	$1,657.60	$1,699.73
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $345.18 / $345.18 / $438.60	Professional	26	$345.18	$345.18	$438.60
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,357.90 / $1,366.92 / $1,366.92	Professional	TC	$1,357.90	$1,366.92	$1,366.92