Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.96 / $126.00 / $171.30	Facility	26	$101.96	$126.00	$171.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $284.64 / $402.08 / $1,459.50	Professional		$284.64	$402.08	$1,459.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.97 / $145.65 / $502.00	Professional	26	$101.97	$145.65	$502.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.85 / $335.00 / $894.64	Professional	TC	$245.85	$335.00	$894.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $253.67 / $335.77 / $858.66	Professional		$253.67	$335.77	$858.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.00 / $135.46 / $214.85	Professional	26	$76.00	$135.46	$214.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $268.14 / $268.14 / $268.14	Professional		$268.14	$268.14	$268.14
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $164.51 / $233.42 / $309.17	Professional	26	$164.51	$233.42	$309.17
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $629.04 / $1,040.83 / $1,420.35	Professional	TC	$629.04	$1,040.83	$1,420.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $116.17	Facility	26	$116.17	$116.17	$116.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $455.63 / $1,010.20 / $1,880.68	Professional		$455.63	$1,010.20	$1,880.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.23 / $167.14 / $292.63	Professional	26	$98.23	$167.14	$292.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $326.69 / $825.16 / $1,648.82	Professional	TC	$326.69	$825.16	$1,648.82
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $155.10 / $176.00 / $314.38	Facility	26	$155.10	$176.00	$314.38
Medcost Facility/Professional Professional Modifier Low / Median / High Price $136.00 / $491.00 / $627.00	Professional		$136.00	$491.00	$627.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $155.10 / $155.10 / $176.00	Professional	26	$155.10	$155.10	$176.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $904.73 / $904.73 / $904.73	Professional	TC	$904.73	$904.73	$904.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $103.68 / $342.89 / $569.95	Professional		$103.68	$342.89	$569.95
United Facility/Professional Professional Modifier Low / Median / High Price $375.84 / $741.07 / $1,283.31	Professional		$375.84	$741.07	$1,283.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $101.26 / $137.56 / $289.61	Professional	26	$101.26	$137.56	$289.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $266.70 / $536.05 / $1,104.48	Professional	TC	$266.70	$536.05	$1,104.48
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $745.12 / $935.44 / $935.44	Facility	26	$745.12	$935.44	$935.44
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $6,158.29 / $6,158.29 / $6,158.29	Professional		$6,158.29	$6,158.29	$6,158.29
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $733.09 / $733.09 / $824.33	Professional	26	$733.09	$733.09	$824.33
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $5,601.93 / $5,601.93 / $5,601.93	Professional	TC	$5,601.93	$5,601.93	$5,601.93