Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.76 / $94.59 / $145.82	Facility	26	$85.76	$94.59	$145.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.26 / $317.81 / $765.00	Professional		$255.26	$317.81	$765.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.50 / $87.34 / $242.83	Professional	26	$76.50	$87.34	$242.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.49 / $220.00 / $460.79	Professional	TC	$169.49	$220.00	$460.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.84 / $102.24 / $180.43	Professional	26	$63.84	$102.24	$180.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $235.28 / $235.28 / $235.28	Professional		$235.28	$235.28	$235.28
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $145.83 / $206.67 / $262.43	Professional	26	$145.83	$206.67	$262.43
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $444.34 / $652.00 / $859.80	Professional	TC	$444.34	$652.00	$859.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.06 / $98.06 / $98.06	Facility	26	$98.06	$98.06	$98.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $392.40 / $657.29 / $1,154.11	Professional		$392.40	$657.29	$1,154.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.13 / $140.41 / $252.88	Professional	26	$87.13	$140.41	$252.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $273.80 / $495.85 / $948.59	Professional	TC	$273.80	$495.85	$948.59
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $137.60 / $156.00 / $258.25	Facility	26	$137.60	$156.00	$258.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $115.00 / $269.00 / $384.00	Professional		$115.00	$269.00	$384.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $137.60 / $137.60 / $156.00	Professional	26	$137.60	$137.60	$156.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $623.72 / $623.72 / $623.72	Professional	TC	$623.72	$623.72	$623.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $110.30 / $284.92 / $517.26	Professional		$110.30	$284.92	$517.26
United Facility/Professional Professional Modifier Low / Median / High Price $309.33 / $544.29 / $927.02	Professional		$309.33	$544.29	$927.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.89 / $128.62 / $248.30	Professional	26	$89.89	$128.62	$248.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $219.05 / $424.21 / $717.19	Professional	TC	$219.05	$424.21	$717.19
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $625.36 / $785.28 / $785.28	Facility	26	$625.36	$785.28	$785.28
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,194.57 / $3,194.57 / $3,194.57	Professional		$3,194.57	$3,194.57	$3,194.57
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $660.44 / $660.44 / $691.43	Professional	26	$660.44	$660.44	$691.43
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,704.69 / $2,704.69 / $2,704.69	Professional	TC	$2,704.69	$2,704.69	$2,704.69