Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.01 / $66.54 / $97.45	Facility	26	$58.01	$66.54	$97.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.58 / $260.86 / $449.62	Professional		$194.58	$260.86	$449.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $58.01 / $155.79	Professional	26	$52.78	$58.01	$155.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $139.94 / $220.00 / $365.88	Professional	TC	$139.94	$220.00	$365.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.34 / $147.34 / $147.34	Professional		$147.34	$147.34	$147.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.32 / $88.14 / $181.44	Professional	26	$48.32	$88.14	$181.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.10 / $152.10 / $152.10	Professional		$152.10	$152.10	$152.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $96.14 / $128.43 / $175.89	Professional	26	$96.14	$128.43	$175.89
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $361.47 / $563.40 / $839.32	Professional	TC	$361.47	$563.40	$839.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.64 / $65.64 / $65.64	Facility	26	$65.64	$65.64	$65.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.64 / $467.44 / $846.97	Professional		$269.64	$467.44	$846.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.93 / $95.46 / $166.35	Professional	26	$55.93	$95.46	$166.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $195.31 / $369.13 / $708.52	Professional	TC	$195.31	$369.13	$708.52
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $80.00 / $87.93 / $178.30	Facility	26	$80.00	$87.93	$178.30
Medcost Facility/Professional Professional Modifier Low / Median / High Price $77.00 / $265.00 / $342.00	Professional		$77.00	$265.00	$342.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $80.00 / $87.93 / $213.48	Professional	26	$80.00	$87.93	$213.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.67 / $192.76 / $331.33	Professional		$72.67	$192.76	$331.33
United Facility/Professional Professional Modifier Low / Median / High Price $234.93 / $401.78 / $735.44	Professional		$234.93	$401.78	$735.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.77 / $82.01 / $168.01	Professional	26	$58.77	$82.01	$168.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.61 / $300.76 / $561.49	Professional	TC	$165.61	$300.76	$561.49
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $414.72 / $522.72 / $522.72	Facility	26	$414.72	$522.72	$522.72
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,019.70 / $2,082.64 / $2,082.64	Professional		$2,019.70	$2,082.64	$2,082.64
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $381.41 / $381.41 / $456.90	Professional	26	$381.41	$381.41	$456.90
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,705.05 / $1,802.98 / $1,802.98	Professional	TC	$1,705.05	$1,802.98	$1,802.98