Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.96 / $116.81 / $171.30	Facility	26	$101.96	$116.81	$171.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $287.10 / $425.00 / $1,459.50	Professional		$287.10	$425.00	$1,459.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.97 / $140.00 / $386.40	Professional	26	$101.97	$140.00	$386.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $297.87 / $335.00 / $931.29	Professional	TC	$297.87	$335.00	$931.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $289.25 / $289.25 / $741.78	Professional		$289.25	$289.25	$741.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.59 / $135.46 / $257.83	Professional	26	$76.59	$135.46	$257.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.00 / $267.00 / $267.00	Professional		$267.00	$267.00	$267.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $165.08 / $238.01 / $310.26	Professional	26	$165.08	$238.01	$310.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $742.30 / $1,014.02 / $1,485.07	Professional	TC	$742.30	$1,014.02	$1,485.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.52 / $116.52 / $116.52	Facility	26	$116.52	$116.52	$116.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $523.79 / $1,047.81 / $1,824.34	Professional		$523.79	$1,047.81	$1,824.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.57 / $167.14 / $294.37	Professional	26	$98.57	$167.14	$294.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $382.12 / $853.15 / $1,625.06	Professional	TC	$382.12	$853.15	$1,625.06
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $155.10 / $177.00 / $286.05	Facility	26	$155.10	$177.00	$286.05
Medcost Facility/Professional Professional Modifier Low / Median / High Price $136.00 / $451.00 / $750.00	Professional		$136.00	$451.00	$750.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $155.10 / $155.10 / $177.00	Professional	26	$155.10	$155.10	$177.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $1,096.16 / $1,096.16 / $1,096.16	Professional	TC	$1,096.16	$1,096.16	$1,096.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $103.68 / $381.57 / $646.21	Professional		$103.68	$381.57	$646.21
United Facility/Professional Professional Modifier Low / Median / High Price $431.00 / $767.36 / $1,309.95	Professional		$431.00	$767.36	$1,309.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.05 / $149.52 / $289.27	Professional	26	$100.05	$149.52	$289.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $330.53 / $616.26 / $1,014.57	Professional	TC	$330.53	$616.26	$1,014.57
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 $6,160.49 / $6,160.49 / $6,160.49	Professional		$6,160.49	$6,160.49	$6,160.49
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $883.52 / $883.52 / $883.52	Professional	26	$883.52	$883.52	$883.52
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