Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.76 / $80.90 / $126.00	Facility	26	$64.76	$80.90	$126.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $425.00 / $1,320.50	Professional		$250.00	$425.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.76 / $118.59 / $259.33	Professional	26	$64.76	$118.59	$259.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.98 / $335.00 / $676.37	Professional	TC	$217.98	$335.00	$676.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $226.14 / $298.99 / $713.29	Professional		$226.14	$298.99	$713.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.95 / $89.28 / $134.84	Professional	26	$47.95	$89.28	$134.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.12 / $167.12 / $167.12	Professional		$167.12	$167.12	$167.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $103.27 / $147.96 / $194.09	Professional	26	$103.27	$147.96	$194.09
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $520.55 / $657.29 / $898.33	Professional	TC	$520.55	$657.29	$898.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $73.64	Facility	26	$73.64	$73.64	$73.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $399.79 / $656.54 / $1,186.50	Professional		$399.79	$656.54	$1,186.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.68 / $105.14 / $185.88	Professional	26	$61.68	$105.14	$185.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $321.50 / $557.49 / $1,033.83	Professional	TC	$321.50	$557.49	$1,033.83
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $96.62 / $111.00 / $199.07	Facility	26	$96.62	$111.00	$199.07
Medcost Facility/Professional Professional Modifier Low / Median / High Price $86.00 / $370.00 / $456.00	Professional		$86.00	$370.00	$456.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $96.62 / $96.62 / $238.32	Professional	26	$96.62	$96.62	$238.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $65.34 / $272.99 / $498.94	Professional		$65.34	$272.99	$498.94
United Facility/Professional Professional Modifier Low / Median / High Price $336.19 / $538.02 / $950.20	Professional		$336.19	$538.02	$950.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.80 / $97.02 / $180.52	Professional	26	$64.80	$97.02	$180.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $274.06 / $466.24 / $762.89	Professional	TC	$274.06	$466.24	$762.89
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $466.08 / $586.88 / $586.88	Facility	26	$466.08	$586.88	$586.88
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,873.43 / $2,873.43 / $2,873.43	Professional		$2,873.43	$2,873.43	$2,873.43
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $469.00 / $469.00 / $514.35	Professional	26	$469.00	$469.00	$514.35
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,524.69 / $2,563.91 / $2,563.91	Professional	TC	$2,524.69	$2,563.91	$2,563.91