Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $141.25 / $316.23	Facility	26	$102.33	$141.25	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $489.78 / $1,659.59	Professional		$234.42	$489.78	$1,659.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $186.21 / $478.63	Professional	26	$97.72	$186.21	$478.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $407.38 / $1,258.93	Professional	TC	$281.84	$407.38	$1,258.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $389.05 / $977.24	Professional		$380.19	$389.05	$977.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $104.71 / $165.96	Professional	26	$95.50	$104.71	$165.96
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $363.08 / $363.08	Professional	TC	$363.08	$363.08	$363.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $234.42 / $309.03	Professional	26	$144.54	$234.42	$309.03
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $691.83 / $1,000.00 / $1,479.11	Professional	TC	$691.83	$1,000.00	$1,479.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $117.49 / $165.96	Facility	26	$25.12	$117.49	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $977.24 / $1,778.28	Professional		$467.74	$977.24	$1,778.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $154.88 / $288.40	Professional	26	$91.20	$154.88	$288.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $741.31 / $1,479.11	Professional	TC	$338.84	$741.31	$1,479.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,621.81	Professional		$1,621.81	$1,621.81	$1,621.81
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $190.55 / $190.55	Professional	26	$190.55	$190.55	$190.55
Medcost Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $363.08 / $776.25	Professional		$104.71	$363.08	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $724.44 / $1,258.93	Professional		$436.52	$724.44	$1,258.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $125.89 / $263.03	Professional	26	$97.72	$125.89	$263.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $549.54 / $1,000.00	Professional	TC	$323.59	$549.54	$1,000.00
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $933.25 / $933.25 / $933.25	Facility	26	$933.25	$933.25	$933.25
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $6,165.95	Professional		$6,165.95	$6,165.95	$6,165.95
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $891.25 / $891.25 / $891.25	Professional	26	$891.25	$891.25	$891.25
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $5,623.41 / $5,623.41 / $5,623.41	Professional	TC	$5,623.41	$5,623.41	$5,623.41