Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $103.66 / $174.14	Facility	26	$83.00	$103.66	$174.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $345.71 / $440.61 / $990.55	Professional		$345.71	$440.61	$990.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.25 / $110.46 / $372.57	Professional	26	$91.25	$110.46	$372.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $253.36 / $342.19 / $676.82	Professional	TC	$253.36	$342.19	$676.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $287.17 / $961.35 / $961.35	Professional		$287.17	$961.35	$961.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $137.63 / $218.30	Professional	26	$77.62	$137.63	$218.30
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $190.00 / $250.01 / $350.38	Professional	TC	$190.00	$250.01	$350.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $255.42 / $255.42 / $255.42	Professional		$255.42	$255.42	$255.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $168.58 / $254.71 / $316.33	Professional	26	$168.58	$254.71	$316.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $626.30 / $785.35 / $1,198.10	Professional	TC	$626.30	$785.35	$1,198.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.52 / $118.52 / $118.52	Facility	26	$118.52	$118.52	$118.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $456.23 / $785.53 / $1,317.46	Professional		$456.23	$785.53	$1,317.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.04 / $169.91 / $300.02	Professional	26	$112.04	$169.91	$300.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $332.47 / $592.70 / $1,061.23	Professional	TC	$332.47	$592.70	$1,061.23
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $153.26 / $240.00 / $321.31	Facility	26	$153.26	$240.00	$321.31
Medcost Facility/Professional Professional Modifier Low / Median / High Price $139.00 / $347.00 / $534.00	Professional		$139.00	$347.00	$534.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $635.04 / $635.04 / $1,046.52	Professional	TC	$635.04	$635.04	$1,046.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $130.06 / $354.16 / $616.49	Professional		$130.06	$354.16	$616.49
United Facility/Professional Professional Modifier Low / Median / High Price $387.31 / $646.55 / $1,234.40	Professional		$387.31	$646.55	$1,234.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.18 / $144.63 / $288.50	Professional	26	$107.18	$144.63	$288.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $278.67 / $495.24 / $839.48	Professional	TC	$278.67	$495.24	$839.48
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $757.60 / $950.32 / $950.32	Facility	26	$757.60	$950.32	$950.32
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,573.48 / $3,239.10 / $3,239.10	Professional		$2,573.48	$3,239.10	$3,239.10
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $653.20 / $838.43 / $838.43	Professional	26	$653.20	$838.43	$838.43
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,099.33 / $2,400.67 / $2,400.67	Professional	TC	$2,099.33	$2,400.67	$2,400.67