Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $36.31 / $107.15	Facility	26	$25.12	$36.31	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $117.49 / $269.15	Professional		$85.11	$117.49	$269.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $28.18 / $95.50	Professional	26	$21.88	$28.18	$95.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $91.20 / $213.80	Professional	TC	$66.07	$91.20	$213.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Professional		$169.82	$169.82	$169.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $30.20 / $36.31	Professional	26	$30.20	$30.20	$36.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Professional		$67.61	$67.61	$67.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $54.95 / $77.62	Professional	26	$41.69	$54.95	$77.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $154.88 / $199.53	Professional	TC	$114.82	$154.88	$199.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $31.62 / $44.67	Facility	26	$6.76	$31.62	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $165.96 / $288.40	Professional		$102.33	$165.96	$288.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $41.69 / $74.13	Professional	26	$23.99	$41.69	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $120.23 / $229.09	Professional	TC	$75.86	$120.23	$229.09
Medcost Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $47.86 / $47.86	Professional	26	$47.86	$47.86	$47.86
Medcost Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $125.89 / $263.03	Professional		$30.20	$125.89	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $134.90 / $251.19	Professional		$97.72	$134.90	$251.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $33.88 / $63.10	Professional	26	$26.30	$33.88	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $100.00 / $186.21	Professional	TC	$69.18	$100.00	$186.21
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $177.83 / $177.83	Facility	26	$177.83	$177.83	$177.83
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $1,047.13	Professional		$870.96	$870.96	$1,047.13
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $199.53 / $223.87	Professional	26	$199.53	$199.53	$223.87
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $691.83 / $691.83 / $831.76	Professional	TC	$691.83	$691.83	$831.76