Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $75.86 / $173.78	Facility	26	$57.54	$75.86	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $245.47 / $724.44	Professional		$138.04	$245.47	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $89.13 / $194.98	Professional	26	$52.48	$89.13	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $138.04 / $338.84	Professional	TC	$81.28	$138.04	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $109.65 / $346.74	Professional		$97.72	$109.65	$346.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $56.23 / $100.00	Professional	26	$42.66	$56.23	$100.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $64.57 / $102.33	Professional	TC	$64.57	$64.57	$102.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Professional		$147.91	$147.91	$147.91
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $138.04 / $173.78	Professional	26	$91.20	$138.04	$173.78
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $295.12 / $501.19	Professional	TC	$208.93	$295.12	$501.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $64.57 / $91.20	Facility	26	$13.80	$64.57	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $309.03 / $501.19	Professional		$151.36	$309.03	$501.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $85.11 / $158.49	Professional	26	$50.12	$85.11	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $204.17 / $380.19	Professional	TC	$89.13	$204.17	$380.19
Medcost Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Professional		$436.52	$436.52	$436.52
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $104.71 / $104.71	Professional	26	$104.71	$104.71	$104.71
Medcost Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $131.83 / $323.59	Professional		$57.54	$131.83	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $239.88 / $389.05	Professional		$141.25	$239.88	$389.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $70.79 / $138.04	Professional	26	$54.95	$70.79	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $158.49 / $263.03	Professional	TC	$83.18	$158.49	$263.03
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $512.86 / $512.86 / $512.86	Facility	26	$512.86	$512.86	$512.86
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,621.81	Professional		$1,621.81	$1,621.81	$1,621.81
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $389.05 / $389.05 / $446.68	Professional	26	$389.05	$389.05	$446.68
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Professional	TC	$1,659.59	$1,659.59	$1,659.59