Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $123.03 / $269.15	Facility	26	$85.11	$123.03	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $354.81 / $1,148.15	Professional		$251.19	$354.81	$1,148.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $120.23 / $295.12	Professional	26	$75.86	$120.23	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $223.87 / $602.56	Professional	TC	$165.96	$223.87	$602.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $87.10 / $173.78	Professional	26	$64.57	$87.10	$173.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $229.09 / $229.09	Professional	TC	$229.09	$229.09	$229.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $208.93 / $263.03	Professional	26	$128.82	$208.93	$263.03
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $645.65 / $851.14	Professional	TC	$398.11	$645.65	$851.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $141.25	Facility	26	$20.89	$97.72	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $616.60 / $1,023.29	Professional		$331.13	$616.60	$1,023.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $131.83 / $239.88	Professional	26	$75.86	$131.83	$239.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $467.74 / $794.33	Professional	TC	$234.42	$467.74	$794.33
Medcost Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $851.14 / $851.14	Professional		$851.14	$851.14	$851.14
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $165.96 / $165.96	Professional	26	$165.96	$165.96	$165.96
Medcost Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Professional		$275.42	$275.42	$275.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $302.00 / $616.60	Professional		$89.13	$302.00	$616.60
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $512.86 / $831.76	Professional		$302.00	$512.86	$831.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $109.65 / $208.93	Professional	26	$83.18	$109.65	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $389.05 / $616.60	Professional	TC	$213.80	$389.05	$616.60
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $794.33 / $794.33 / $794.33	Facility	26	$794.33	$794.33	$794.33
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $3,162.28	Professional		$3,162.28	$3,162.28	$3,162.28
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $660.69 / $660.69 / $691.83	Professional	26	$660.69	$660.69	$691.83
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,691.53 / $2,691.53 / $2,691.53	Professional	TC	$2,691.53	$2,691.53	$2,691.53