Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.71 / $69.51 / $101.54	Facility	26	$60.71	$69.51	$101.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.91 / $282.08 / $963.35	Professional		$229.91	$282.08	$963.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.86 / $64.14 / $175.49	Professional	26	$54.86	$64.14	$175.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.21 / $248.90 / $436.02	Professional	TC	$169.21	$248.90	$436.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.82 / $576.91 / $576.91	Professional		$173.82	$576.91	$576.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.60 / $80.38 / $126.34	Professional	26	$44.60	$80.38	$126.34
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $154.38 / $154.38 / $154.38	Professional	TC	$154.38	$154.38	$154.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.22 / $158.22 / $158.22	Professional		$158.22	$158.22	$158.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.97 / $147.81 / $184.73	Professional	26	$100.97	$147.81	$184.73
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $378.93 / $467.86 / $714.91	Professional	TC	$378.93	$467.86	$714.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $279.02 / $453.09 / $791.30	Professional		$279.02	$453.09	$791.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.68 / $99.23 / $174.60	Professional	26	$58.68	$99.23	$174.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $207.93 / $347.07 / $621.42	Professional	TC	$207.93	$347.07	$621.42
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $91.56 / $135.00 / $200.00	Facility	26	$91.56	$135.00	$200.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $208.00 / $324.00	Professional		$81.00	$208.00	$324.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $91.56 / $91.56 / $223.41	Professional	26	$91.56	$91.56	$223.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $77.09 / $217.66 / $389.70	Professional		$77.09	$217.66	$389.70
United Facility/Professional Professional Modifier Low / Median / High Price $236.37 / $350.69 / $656.46	Professional		$236.37	$350.69	$656.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.32 / $89.01 / $174.85	Professional	26	$61.32	$89.01	$174.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $172.79 / $279.93 / $498.21	Professional	TC	$172.79	$279.93	$498.21
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $436.88 / $549.76 / $549.76	Facility	26	$436.88	$549.76	$549.76
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,902.16 / $1,902.16 / $1,964.18	Professional		$1,902.16	$1,902.16	$1,964.18
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $444.14 / $444.14 / $482.33	Professional	26	$444.14	$444.14	$482.33
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,104.00 / $2,104.00 / $2,104.00	Professional	TC	$2,104.00	$2,104.00	$2,104.00