Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.18 / $98.93 / $150.61	Facility	26	$89.18	$98.93	$150.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $258.31 / $303.68 / $638.95	Professional		$258.31	$303.68	$638.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.51 / $89.18 / $258.07	Professional	26	$78.51	$89.18	$258.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.13 / $220.00 / $418.99	Professional	TC	$169.13	$220.00	$418.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.87 / $90.05 / $166.76	Professional	26	$66.87	$90.05	$166.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $235.28 / $235.28 / $235.28	Professional		$235.28	$235.28	$235.28
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $145.87 / $219.02 / $274.51	Professional	26	$145.87	$219.02	$274.51
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $442.30 / $700.52 / $859.49	Professional	TC	$442.30	$700.52	$859.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.96 / $101.96 / $101.96	Facility	26	$101.96	$101.96	$101.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $387.32 / $662.38 / $1,115.35	Professional		$387.32	$662.38	$1,115.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.82 / $141.06 / $258.87	Professional	26	$87.82	$141.06	$258.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $279.39 / $512.79 / $914.92	Professional	TC	$279.39	$512.79	$914.92
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $124.00 / $138.26 / $237.33	Facility	26	$124.00	$138.26	$237.33
Medcost Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $324.00 / $444.00	Professional		$120.00	$324.00	$444.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $124.00 / $138.26 / $138.26	Professional	26	$124.00	$138.26	$138.26
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $915.87 / $915.87 / $1,425.87	Professional	50	$915.87	$915.87	$1,425.87
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $622.40 / $622.40 / $622.40	Professional	TC	$622.40	$622.40	$622.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $113.17 / $297.73 / $537.02	Professional		$113.17	$297.73	$537.02
United Facility/Professional Professional Modifier Low / Median / High Price $339.68 / $541.45 / $950.29	Professional		$339.68	$541.45	$950.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.84 / $133.19 / $267.27	Professional	26	$91.84	$133.19	$267.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $246.16 / $409.05 / $698.23	Professional	TC	$246.16	$409.05	$698.23
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $649.67 / $816.32 / $816.32	Facility	26	$649.67	$816.32	$816.32
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,965.02 / $2,965.02 / $2,965.02	Professional		$2,965.02	$2,965.02	$2,965.02
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $561.99 / $561.99 / $717.75	Professional	26	$561.99	$561.99	$717.75
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,472.65 / $2,472.65 / $2,472.65	Professional	TC	$2,472.65	$2,472.65	$2,472.65