Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $91.93 / $134.22	Facility	26	$83.00	$91.93	$134.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.64 / $341.58 / $1,407.00	Professional		$281.64	$341.58	$1,407.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.84 / $108.17 / $323.00	Professional	26	$79.84	$108.17	$323.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.00 / $260.57 / $674.96	Professional	TC	$220.00	$260.57	$674.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $228.01 / $557.22 / $772.17	Professional		$228.01	$557.22	$772.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.44 / $133.30 / $218.63	Professional	26	$64.44	$133.30	$218.63
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $168.15 / $272.17 / $276.48	Professional	TC	$168.15	$272.17	$276.48
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $142.88 / $214.03 / $265.41	Professional	26	$142.88	$214.03	$265.41
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $398.10 / $499.62 / $682.79	Professional	TC	$398.10	$499.62	$682.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.40 / $98.40 / $98.40	Facility	26	$98.40	$98.40	$98.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $347.73 / $535.88 / $899.28	Professional		$347.73	$535.88	$899.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $94.43 / $143.21 / $249.33	Professional	26	$94.43	$143.21	$249.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $252.28 / $387.58 / $652.67	Professional	TC	$252.28	$387.58	$652.67
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $129.90 / $129.90 / $247.83	Facility	26	$129.90	$129.90	$247.83
Medcost Facility/Professional Professional Modifier Low / Median / High Price $116.00 / $273.00 / $424.00	Professional		$116.00	$273.00	$424.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $129.90 / $129.90 / $129.90	Professional	26	$129.90	$129.90	$129.90
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $834.07 / $834.07 / $834.07	Professional	TC	$834.07	$834.07	$834.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $108.49 / $281.33 / $465.10	Professional		$108.49	$281.33	$465.10
United Facility/Professional Professional Modifier Low / Median / High Price $313.02 / $455.25 / $858.48	Professional		$313.02	$455.25	$858.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.35 / $123.61 / $246.15	Professional	26	$89.35	$123.61	$246.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $222.07 / $320.49 / $617.73	Professional	TC	$222.07	$320.49	$617.73
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $630.16 / $791.44 / $791.44	Facility	26	$630.16	$791.44	$791.44
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,077.84 / $2,569.28 / $2,569.28	Professional		$2,077.84	$2,569.28	$2,569.28
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $547.02 / $697.13 / $697.13	Professional	26	$547.02	$697.13	$697.13
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,614.00 / $2,614.00 / $2,614.00	Professional	TC	$2,614.00	$2,614.00	$2,614.00