Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.05 / $31.85 / $53.96	Facility	26	$30.05	$31.85	$53.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.02 / $107.06 / $284.54	Professional		$97.02	$107.06	$284.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.89 / $31.21 / $92.90	Professional	26	$28.89	$31.21	$92.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.73 / $69.33 / $133.47	Professional	TC	$65.73	$69.33	$133.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.58 / $80.58 / $80.58	Professional		$80.58	$80.58	$80.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.87 / $47.88 / $69.73	Professional	26	$24.87	$47.88	$69.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.61 / $138.61 / $138.61	Professional		$138.61	$138.61	$138.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.23 / $78.44 / $100.60	Professional	26	$54.23	$78.44	$100.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $111.45 / $156.41 / $200.59	Professional	TC	$111.45	$156.41	$200.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.73 / $165.64 / $285.14	Professional		$106.73	$165.64	$285.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.04 / $54.49 / $94.93	Professional	26	$36.04	$54.49	$94.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.69 / $114.79 / $190.61	Professional	TC	$70.69	$114.79	$190.61
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $51.68 / $52.22 / $80.84	Facility	26	$51.68	$52.22	$80.84
Medcost Facility/Professional Professional Modifier Low / Median / High Price $43.00 / $139.00 / $406.35	Professional		$43.00	$139.00	$406.35
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $52.22 / $52.22 / $122.88	Professional	26	$52.22	$52.22	$122.88
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $104.11 / $104.11 / $104.11	Professional	TC	$104.11	$104.11	$104.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $49.18 / $127.50 / $188.24	Professional		$49.18	$127.50	$188.24
United Facility/Professional Professional Modifier Low / Median / High Price $97.98 / $136.77 / $269.06	Professional		$97.98	$136.77	$269.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.94 / $48.57 / $86.99	Professional	26	$33.94	$48.57	$86.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.86 / $95.41 / $180.88	Professional	TC	$68.86	$95.41	$180.88
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $78.25 / $162.16 / $162.16	Facility	26	$78.25	$162.16	$162.16
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $730.62 / $905.33 / $905.33	Professional		$730.62	$905.33	$905.33
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $210.44 / $267.68 / $267.68	Professional	26	$210.44	$267.68	$267.68
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $520.19 / $637.65 / $637.65	Professional	TC	$520.19	$637.65	$637.65