Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.76 / $76.13 / $111.55	Facility	26	$66.76	$76.13	$111.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.93 / $302.52 / $1,116.46	Professional		$235.93	$302.52	$1,116.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.87 / $67.06 / $191.60	Professional	26	$58.87	$67.06	$191.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.17 / $263.31 / $468.94	Professional	TC	$169.17	$263.31	$468.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.91 / $452.24 / $592.16	Professional		$194.91	$452.24	$592.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $49.24 / $91.71 / $138.49	Professional	26	$49.24	$91.71	$138.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.37 / $241.73 / $241.73	Professional	TC	$162.37	$241.73	$241.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.82 / $173.82 / $173.82	Professional		$173.82	$173.82	$173.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $110.46 / $161.41 / $202.09	Professional	26	$110.46	$161.41	$202.09
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $406.82 / $593.47 / $839.63	Professional	TC	$406.82	$593.47	$839.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.64 / $75.64 / $75.64	Facility	26	$75.64	$75.64	$75.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $312.95 / $533.10 / $967.48	Professional		$312.95	$533.10	$967.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.23 / $109.26 / $191.75	Professional	26	$64.23	$109.26	$191.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $235.07 / $412.19 / $808.45	Professional	TC	$235.07	$412.19	$808.45
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $101.25 / $148.16 / $240.00	Facility	26	$101.25	$148.16	$240.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $89.00 / $239.00 / $345.00	Professional		$89.00	$239.00	$345.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $101.25 / $101.25 / $245.71	Professional	26	$101.25	$101.25	$245.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $84.43 / $246.55 / $437.50	Professional		$84.43	$246.55	$437.50
United Facility/Professional Professional Modifier Low / Median / High Price $266.38 / $433.80 / $746.19	Professional		$266.38	$433.80	$746.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.51 / $97.89 / $197.02	Professional	26	$67.51	$97.89	$197.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $196.55 / $346.80 / $555.36	Professional	TC	$196.55	$346.80	$555.36
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $478.24 / $602.48 / $602.48	Facility	26	$478.24	$602.48	$602.48
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,308.83 / $2,385.40 / $2,385.40	Professional		$2,308.83	$2,385.40	$2,385.40
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $533.30 / $533.30 / $533.30	Professional	26	$533.30	$533.30	$533.30
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,603.00 / $2,603.00 / $2,603.00	Professional	TC	$2,603.00	$2,603.00	$2,603.00