Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.48 / $86.81 / $126.00	Facility	26	$69.48	$86.81	$126.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.80 / $400.00 / $1,047.93	Professional		$200.80	$400.00	$1,047.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.48 / $126.00 / $322.00	Professional	26	$69.48	$126.00	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.31 / $281.41 / $507.17	Professional	TC	$131.31	$281.41	$507.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $148.22 / $498.65 / $498.65	Professional		$148.22	$498.65	$498.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.45 / $92.38 / $173.75	Professional	26	$51.45	$92.38	$173.75
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $327.00 / $327.00 / $327.00	Professional	TC	$327.00	$327.00	$327.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.02 / $182.02 / $182.02	Professional		$182.02	$182.02	$182.02
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.20 / $169.08 / $211.33	Professional	26	$113.20	$169.08	$211.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $415.12 / $647.71 / $896.10	Professional	TC	$415.12	$647.71	$896.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $79.09 / $79.09	Facility	26	$79.09	$79.09	$79.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.57 / $586.65 / $1,092.86	Professional		$271.57	$586.65	$1,092.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.20 / $113.57 / $200.46	Professional	26	$67.20	$113.57	$200.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $178.65 / $443.89 / $939.53	Professional	TC	$178.65	$443.89	$939.53
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $104.91 / $120.00 / $215.35	Facility	26	$104.91	$120.00	$215.35
Medcost Facility/Professional Professional Modifier Low / Median / High Price $92.00 / $323.00 / $450.00	Professional		$92.00	$323.00	$450.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $104.91 / $104.91 / $255.72	Professional	26	$104.91	$104.91	$255.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $69.33 / $191.24 / $330.78	Professional		$69.33	$191.24	$330.78
United Facility/Professional Professional Modifier Low / Median / High Price $228.81 / $449.29 / $839.20	Professional		$228.81	$449.29	$839.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.84 / $105.64 / $207.83	Professional	26	$69.84	$105.64	$207.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $150.07 / $331.86 / $649.82	Professional	TC	$150.07	$331.86	$649.82
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $500.48 / $629.60 / $629.60	Facility	26	$500.48	$629.60	$629.60
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,916.35 / $2,916.35 / $2,916.35	Professional		$2,916.35	$2,916.35	$2,916.35
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $579.54 / $579.54 / $579.54	Professional	26	$579.54	$579.54	$579.54
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,539.44 / $2,539.44 / $2,539.44	Professional	TC	$2,539.44	$2,539.44	$2,539.44