Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.96 / $65.37 / $94.80	Facility	26	$56.96	$65.37	$94.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.15 / $223.90 / $725.00	Professional		$139.15	$223.90	$725.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.28 / $59.87 / $163.25	Professional	26	$51.28	$59.87	$163.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.18 / $143.43 / $253.10	Professional	TC	$82.18	$143.43	$253.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.61 / $346.04 / $346.04	Professional		$103.61	$346.04	$346.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.96 / $86.54 / $118.01	Professional	26	$41.96	$86.54	$118.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.41 / $148.41 / $148.41	Professional		$148.41	$148.41	$148.41
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.33 / $136.59 / $172.45	Professional	26	$94.33	$136.59	$172.45
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $226.94 / $301.88 / $492.59	Professional	TC	$226.94	$301.88	$492.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.44 / $64.44 / $64.44	Facility	26	$64.44	$64.44	$64.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.93 / $331.53 / $589.05	Professional		$168.93	$331.53	$589.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.82 / $92.79 / $162.99	Professional	26	$54.82	$92.79	$162.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $101.72 / $214.35 / $463.94	Professional	TC	$101.72	$214.35	$463.94
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $85.85 / $128.00 / $198.00	Facility	26	$85.85	$128.00	$198.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $76.00 / $112.00 / $225.00	Professional		$76.00	$112.00	$225.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $85.85 / $85.85 / $209.65	Professional	26	$85.85	$85.85	$209.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $71.93 / $121.31 / $242.53	Professional		$71.93	$121.31	$242.53
United Facility/Professional Professional Modifier Low / Median / High Price $143.54 / $257.83 / $428.10	Professional		$143.54	$257.83	$428.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.22 / $77.22 / $160.30	Professional	26	$57.22	$77.22	$160.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.19 / $163.06 / $263.12	Professional	TC	$84.19	$163.06	$263.12
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $407.44 / $513.44 / $513.44	Facility	26	$407.44	$513.44	$513.44
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,608.41 / $1,608.41 / $1,608.41	Professional		$1,608.41	$1,608.41	$1,608.41
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $386.35 / $386.35 / $449.18	Professional	26	$386.35	$386.35	$449.18
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,649.00 / $1,649.00 / $1,649.00	Professional	TC	$1,649.00	$1,649.00	$1,649.00