Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.12 / $94.23 / $143.46	Facility	26	$85.12	$94.23	$143.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $342.85 / $425.00 / $1,109.39	Professional		$342.85	$425.00	$1,109.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.12 / $118.59 / $222.85	Professional	26	$85.12	$118.59	$222.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.73 / $335.00 / $705.33	Professional	TC	$257.73	$335.00	$705.33
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $379.81 / $379.81 / $379.81	Professional	50	$379.81	$379.81	$379.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $227.80 / $227.80 / $227.80	Professional		$227.80	$227.80	$227.80
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $139.69 / $191.92 / $261.42	Professional	26	$139.69	$191.92	$261.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $313.36 / $777.52 / $1,034.06	Professional	TC	$313.36	$777.52	$1,034.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.37 / $97.37 / $97.37	Facility	26	$97.37	$97.37	$97.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $449.14 / $718.04 / $1,238.83	Professional		$449.14	$718.04	$1,238.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.44 / $141.69 / $246.57	Professional	26	$83.44	$141.69	$246.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $337.62 / $569.82 / $1,048.34	Professional	TC	$337.62	$569.82	$1,048.34
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $131.54 / $150.00 / $245.99	Facility	26	$131.54	$150.00	$245.99
Medcost Facility/Professional Professional Modifier Low / Median / High Price $114.00 / $387.00 / $501.00	Professional		$114.00	$387.00	$501.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $131.54 / $131.54 / $150.00	Professional	26	$131.54	$131.54	$150.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $1,213.95 / $1,213.95 / $1,892.53	Professional	50	$1,213.95	$1,213.95	$1,892.53
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $948.45 / $948.45 / $948.45	Professional	TC	$948.45	$948.45	$948.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $86.63 / $316.08 / $571.66	Professional		$86.63	$316.08	$571.66
United Facility/Professional Professional Modifier Low / Median / High Price $375.94 / $628.17 / $1,044.31	Professional		$375.94	$628.17	$1,044.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.67 / $129.29 / $242.52	Professional	26	$84.67	$129.29	$242.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $290.24 / $475.44 / $802.78	Professional	TC	$290.24	$475.44	$802.78
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $620.48 / $779.12 / $779.12	Facility	26	$620.48	$779.12	$779.12
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,045.40 / $3,045.40 / $3,045.40	Professional		$3,045.40	$3,045.40	$3,045.40
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $850.86 / $850.86 / $850.86	Professional	26	$850.86	$850.86	$850.86
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,573.94 / $2,616.37 / $2,616.37	Professional	TC	$2,573.94	$2,616.37	$2,616.37