Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.04 / $63.43 / $92.54	Facility	26	$55.04	$63.43	$92.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.55 / $255.77 / $519.49	Professional		$165.55	$255.77	$519.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $58.49 / $277.00	Professional	26	$50.07	$58.49	$277.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $113.97 / $198.79 / $380.07	Professional	TC	$113.97	$198.79	$380.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $420.98 / $420.98 / $420.98	Professional		$420.98	$420.98	$420.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.94 / $78.70 / $138.75	Professional	26	$40.94	$78.70	$138.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.77 / $144.77 / $144.77	Professional		$144.77	$144.77	$144.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.72 / $136.74 / $167.80	Professional	26	$91.72	$136.74	$167.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $293.27 / $425.33 / $691.65	Professional	TC	$293.27	$425.33	$691.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.89 / $62.89 / $62.89	Facility	26	$62.89	$62.89	$62.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.89 / $387.58 / $671.66	Professional		$230.89	$387.58	$671.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.34 / $90.64 / $158.56	Professional	26	$53.34	$90.64	$158.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.55 / $287.44 / $549.90	Professional	TC	$158.55	$287.44	$549.90
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $83.78 / $95.00 / $175.48	Facility	26	$83.78	$95.00	$175.48
Medcost Facility/Professional Professional Modifier Low / Median / High Price $74.00 / $209.00 / $282.00	Professional		$74.00	$209.00	$282.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $83.78 / $83.78 / $202.58	Professional	26	$83.78	$83.78	$202.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $69.58 / $167.30 / $287.60	Professional		$69.58	$167.30	$287.60
United Facility/Professional Professional Modifier Low / Median / High Price $194.75 / $313.67 / $553.04	Professional		$194.75	$313.67	$553.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.68 / $80.34 / $153.88	Professional	26	$55.68	$80.34	$153.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.82 / $234.08 / $394.08	Professional	TC	$127.82	$234.08	$394.08
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $397.76 / $501.04 / $501.04	Facility	26	$397.76	$501.04	$501.04
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,657.60 / $1,657.60 / $1,657.60	Professional		$1,657.60	$1,657.60	$1,657.60
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $376.34 / $376.34 / $438.60	Professional	26	$376.34	$376.34	$438.60
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,357.90 / $1,371.93 / $1,371.93	Professional	TC	$1,357.90	$1,371.93	$1,371.93