Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $75.86 / $169.82	Facility	26	$54.95	$75.86	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $229.09 / $588.84	Professional		$123.03	$229.09	$588.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $87.10 / $194.98	Professional	26	$51.29	$87.10	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $204.17 / $478.63	Professional	TC	$144.54	$204.17	$478.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $69.18 / $112.20	Professional	26	$40.74	$69.18	$112.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $102.33 / $102.33	Professional	TC	$102.33	$102.33	$102.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Professional		$144.54	$144.54	$144.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $138.04 / $169.82	Professional	26	$89.13	$138.04	$169.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $457.09 / $676.08	Professional	TC	$309.03	$457.09	$676.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $61.66 / $89.13	Facility	26	$13.49	$61.66	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $389.05 / $660.69	Professional		$223.87	$389.05	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $83.18 / $154.88	Professional	26	$48.98	$83.18	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $302.00 / $512.86	Professional	TC	$162.18	$302.00	$512.86
Medcost Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Professional		$457.09	$457.09	$457.09
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $102.33 / $102.33	Professional	26	$102.33	$102.33	$102.33
Medcost Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $204.17 / $436.52	Professional		$56.23	$204.17	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $309.03 / $524.81	Professional		$208.93	$309.03	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $69.18 / $131.83	Professional	26	$53.70	$69.18	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $234.42 / $407.38	Professional	TC	$154.88	$234.42	$407.38
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $501.19 / $501.19 / $501.19	Facility	26	$501.19	$501.19	$501.19
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,698.24	Professional		$1,659.59	$1,659.59	$1,698.24
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $346.74 / $346.74 / $436.52	Professional	26	$346.74	$346.74	$436.52
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,348.96 / $1,380.38 / $1,380.38	Professional	TC	$1,348.96	$1,380.38	$1,380.38