Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $190.55 / $446.68	Facility	26	$112.20	$190.55	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $269.15 / $616.60	Professional		$186.21	$269.15	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $120.23 / $309.03	Professional	26	$54.95	$120.23	$309.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $131.83 / $281.84	Professional	TC	$102.33	$131.83	$281.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $87.10 / $239.88	Professional	26	$87.10	$87.10	$239.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $223.87 / $223.87	Professional	TC	$223.87	$223.87	$223.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Professional		$263.03	$263.03	$263.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $234.42 / $338.84	Professional	26	$162.18	$234.42	$338.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $323.59 / $537.03	Professional	TC	$229.09	$323.59	$537.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $128.82 / $186.21	Facility	26	$27.54	$128.82	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $660.69 / $1,202.26	Professional		$407.38	$660.69	$1,202.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $169.82 / $316.23	Professional	26	$102.33	$169.82	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $489.78 / $870.96	Professional	TC	$295.12	$489.78	$870.96
Medcost Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Professional		$645.65	$645.65	$645.65
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $190.55 / $190.55	Professional	26	$190.55	$190.55	$190.55
Medcost Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Professional		$281.84	$281.84	$281.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $870.96 / $1,995.26	Professional		$478.63	$870.96	$1,995.26
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $537.03 / $1,071.52	Professional		$398.11	$537.03	$1,071.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $141.25 / $275.42	Professional	26	$107.15	$141.25	$275.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $398.11 / $776.25	Professional	TC	$302.00	$398.11	$776.25
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility	26	$1,047.13	$1,047.13	$1,047.13
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $1,995.26 / $1,995.26	Professional		$1,862.09	$1,995.26	$1,995.26
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $724.44 / $724.44 / $912.01	Professional	26	$724.44	$724.44	$912.01
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,348.96 / $1,479.11 / $1,479.11	Professional	TC	$1,348.96	$1,479.11	$1,479.11