Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $74.13 / $169.82	Facility	26	$54.95	$74.13	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $194.98 / $537.03	Professional		$112.20	$194.98	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $100.00 / $245.47	Professional	26	$51.29	$100.00	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $190.55 / $436.52	Professional	TC	$112.20	$190.55	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $194.98 / $416.87	Professional		$147.91	$194.98	$416.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $54.95 / $102.33	Professional	26	$40.74	$54.95	$102.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $102.33 / $144.54	Professional	TC	$102.33	$102.33	$144.54
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 $275.42 / $416.87 / $691.83	Professional	TC	$275.42	$416.87	$691.83
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 $199.53 / $371.54 / $630.96	Professional		$199.53	$371.54	$630.96
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 $138.04 / $281.84 / $478.63	Professional	TC	$138.04	$281.84	$478.63
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 / $158.49 / $407.38	Professional		$56.23	$158.49	$407.38
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $288.40 / $512.86	Professional		$186.21	$288.40	$512.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $69.18 / $134.90	Professional	26	$53.70	$69.18	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $223.87 / $380.19	Professional	TC	$128.82	$223.87	$380.19
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 / $1,659.59	Professional		$1,659.59	$1,659.59	$1,659.59
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $380.19 / $380.19 / $436.52	Professional	26	$380.19	$380.19	$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