Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.01 / $126.00 / $354.19	Facility	26	$104.01	$126.00	$354.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $348.58 / $475.00 / $1,824.12	Professional		$348.58	$475.00	$1,824.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.41 / $140.00 / $425.49	Professional	26	$97.41	$140.00	$425.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $244.56 / $335.00 / $914.90	Professional	TC	$244.56	$335.00	$914.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $255.52 / $545.86 / $861.39	Professional		$255.52	$545.86	$861.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.69 / $138.91 / $219.17	Professional	26	$77.69	$138.91	$219.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $211.65 / $495.19 / $495.19	Professional	TC	$211.65	$495.19	$495.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.02 / $281.02 / $281.02	Professional		$281.02	$281.02	$281.02
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $173.12 / $254.79 / $319.31	Professional	26	$173.12	$254.79	$319.31
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $634.05 / $1,158.83 / $1,484.05	Professional	TC	$634.05	$1,158.83	$1,484.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $456.64 / $1,027.17 / $1,893.79	Professional		$456.64	$1,027.17	$1,893.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.40 / $175.20 / $309.62	Professional	26	$103.40	$175.20	$309.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $325.22 / $821.09 / $1,651.24	Professional	TC	$325.22	$821.09	$1,651.24
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $162.88 / $218.00 / $342.04	Facility	26	$162.88	$218.00	$342.04
Medcost Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $489.00 / $750.00	Professional		$144.00	$489.00	$750.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $218.00 / $382.79 / $382.79	Professional	26	$218.00	$382.79	$382.79
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $742.85 / $742.85 / $742.85	Professional	TC	$742.85	$742.85	$742.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $106.08 / $343.86 / $572.49	Professional		$106.08	$343.86	$572.49
United Facility/Professional Professional Modifier Low / Median / High Price $385.43 / $747.60 / $1,436.88	Professional		$385.43	$747.60	$1,436.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.20 / $147.76 / $303.51	Professional	26	$107.20	$147.76	$303.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $270.64 / $554.67 / $1,099.50	Professional	TC	$270.64	$554.67	$1,099.50
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $759.68 / $954.08 / $954.08	Facility	26	$759.68	$954.08	$954.08
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $6,206.15 / $6,206.15 / $6,206.15	Professional		$6,206.15	$6,206.15	$6,206.15
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $891.52 / $891.52 / $891.52	Professional	26	$891.52	$891.52	$891.52
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $5,621.63 / $5,621.63 / $5,621.63	Professional	TC	$5,621.63	$5,621.63	$5,621.63