Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.29 / $116.81 / $171.84	Facility	26	$102.29	$116.81	$171.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.98 / $425.00 / $1,320.50	Professional		$295.98	$425.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.29 / $140.00 / $439.23	Professional	26	$102.29	$140.00	$439.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $321.95 / $340.00 / $1,020.25	Professional	TC	$321.95	$340.00	$1,020.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $307.87 / $1,043.72 / $1,043.72	Professional		$307.87	$1,043.72	$1,043.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.75 / $103.13 / $214.85	Professional	26	$75.75	$103.13	$214.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $268.14 / $268.14 / $268.14	Professional		$268.14	$268.14	$268.14
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $165.08 / $233.62 / $310.26	Professional	26	$165.08	$233.62	$310.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $718.52 / $1,048.46 / $1,420.35	Professional	TC	$718.52	$1,048.46	$1,420.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.52 / $116.52 / $116.52	Facility	26	$116.52	$116.52	$116.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $544.53 / $1,057.79 / $1,881.48	Professional		$544.53	$1,057.79	$1,881.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.57 / $167.66 / $294.37	Professional	26	$98.57	$167.66	$294.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $415.98 / $885.38 / $1,660.45	Professional	TC	$415.98	$885.38	$1,660.45
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $155.10 / $177.00 / $315.36	Facility	26	$155.10	$177.00	$315.36
Medcost Facility/Professional Professional Modifier Low / Median / High Price $136.00 / $488.00 / $624.00	Professional		$136.00	$488.00	$624.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $155.10 / $155.10 / $376.43	Professional	26	$155.10	$155.10	$376.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $103.81 / $382.59 / $680.10	Professional		$103.81	$382.59	$680.10
United Facility/Professional Professional Modifier Low / Median / High Price $461.38 / $799.96 / $1,391.11	Professional		$461.38	$799.96	$1,391.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $103.63 / $141.86 / $293.98	Professional	26	$103.63	$141.86	$293.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $351.66 / $665.42 / $1,096.47	Professional	TC	$351.66	$665.42	$1,096.47
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $745.12 / $935.44 / $935.44	Facility	26	$745.12	$935.44	$935.44
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $6,160.49 / $6,160.49 / $6,160.49	Professional		$6,160.49	$6,160.49	$6,160.49
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $672.78 / $672.78 / $824.33	Professional	26	$672.78	$672.78	$824.33
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $5,601.93 / $5,601.93 / $5,601.93	Professional	TC	$5,601.93	$5,601.93	$5,601.93