Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.04 / $75.06 / $126.00	Facility	26	$65.04	$75.06	$126.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.00 / $370.50 / $1,127.23	Professional		$184.00	$370.50	$1,127.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.04 / $126.00 / $358.86	Professional	26	$65.04	$126.00	$358.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $123.18 / $373.16 / $500.97	Professional	50	$123.18	$373.16	$500.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $103.14 / $123.69 / $300.00	Professional	52	$103.14	$123.69	$300.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.22 / $305.06 / $670.00	Professional	TC	$141.22	$305.06	$670.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $178.62 / $375.76 / $1,047.61	Professional		$178.62	$375.76	$1,047.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.95 / $91.11 / $162.53	Professional	26	$47.95	$91.11	$162.53
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $102.36 / $210.15 / $210.15	Professional	TC	$102.36	$210.15	$210.15
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 $103.62 / $151.88 / $194.09	Professional	26	$103.62	$151.88	$194.09
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $404.11 / $606.50 / $898.01	Professional	TC	$404.11	$606.50	$898.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $73.64	Facility	26	$73.64	$73.64	$73.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $270.22 / $554.30 / $1,135.63	Professional		$270.22	$554.30	$1,135.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.68 / $106.09 / $188.60	Professional	26	$61.68	$106.09	$188.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $183.10 / $413.34 / $994.81	Professional	TC	$183.10	$413.34	$994.81
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $97.46 / $142.71 / $228.00	Facility	26	$97.46	$142.71	$228.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $86.00 / $210.00 / $450.00	Professional		$86.00	$210.00	$450.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $97.46 / $97.46 / $130.00	Professional	26	$97.46	$97.46	$130.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $873.68 / $873.68 / $1,138.60	Professional	50	$873.68	$873.68	$1,138.60
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $519.73 / $519.73 / $519.73	Professional	TC	$519.73	$519.73	$519.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $65.34 / $207.03 / $347.86	Professional		$65.34	$207.03	$347.86
United Facility/Professional Professional Modifier Low / Median / High Price $219.28 / $434.13 / $683.11	Professional		$219.28	$434.13	$683.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.81 / $94.60 / $185.57	Professional	26	$64.81	$94.60	$185.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.58 / $293.85 / $561.50	Professional	TC	$151.58	$293.85	$561.50
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $466.08 / $586.88 / $586.88	Facility	26	$466.08	$586.88	$586.88
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 $525.38 / $525.38 / $525.38	Professional	26	$525.38	$525.38	$525.38
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,524.69 / $2,524.69 / $2,524.69	Professional	TC	$2,524.69	$2,524.69	$2,524.69