Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.12 / $78.84 / $126.00	Facility	26	$64.12	$78.84	$126.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.43 / $425.00 / $1,320.50	Professional		$229.43	$425.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.12 / $119.28 / $339.66	Professional	26	$64.12	$119.28	$339.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $338.18 / $712.50 / $712.50	Professional	50	$338.18	$712.50	$712.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $165.31 / $335.00 / $676.37	Professional	TC	$165.31	$335.00	$676.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $167.86 / $221.76 / $567.80	Professional		$167.86	$221.76	$567.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.71 / $71.06 / $134.19	Professional	26	$47.71	$71.06	$134.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $232.98 / $232.98 / $374.75	Professional	TC	$232.98	$232.98	$374.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.12 / $167.12 / $167.12	Professional		$167.12	$167.12	$167.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $103.27 / $146.08 / $194.09	Professional	26	$103.27	$146.08	$194.09
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $430.06 / $657.29 / $898.33	Professional	TC	$430.06	$657.29	$898.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $307.81 / $601.30 / $1,151.45	Professional		$307.81	$601.30	$1,151.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.68 / $104.98 / $184.96	Professional	26	$61.68	$104.98	$184.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.88 / $479.31 / $993.31	Professional	TC	$223.88	$479.31	$993.31
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $97.46 / $111.00 / $198.06	Facility	26	$97.46	$111.00	$198.06
Medcost Facility/Professional Professional Modifier Low / Median / High Price $86.00 / $369.00 / $455.00	Professional		$86.00	$369.00	$455.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $97.46 / $97.46 / $235.96	Professional	26	$97.46	$97.46	$235.96
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $873.68 / $873.68 / $1,266.45	Professional	50	$873.68	$873.68	$1,266.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.66 / $227.15 / $377.47	Professional		$64.66	$227.15	$377.47
United Facility/Professional Professional Modifier Low / Median / High Price $246.25 / $486.17 / $895.58	Professional		$246.25	$486.17	$895.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.80 / $89.22 / $186.40	Professional	26	$64.80	$89.22	$186.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $183.44 / $376.35 / $738.17	Professional	TC	$183.44	$376.35	$738.17
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $463.68 / $583.84 / $583.84	Facility	26	$463.68	$583.84	$583.84
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,873.43 / $2,873.43 / $2,873.43	Professional		$2,873.43	$2,873.43	$2,873.43
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $531.65 / $531.65 / $531.65	Professional	26	$531.65	$531.65	$531.65
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,524.69 / $2,526.42 / $2,526.42	Professional	TC	$2,524.69	$2,526.42	$2,526.42