Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $125.99 / $191.81	Facility	26	$83.00	$125.99	$191.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.78 / $217.16 / $384.92	Professional		$191.78	$217.16	$384.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.00 / $113.79 / $176.10	Professional	26	$83.00	$113.79	$176.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $103.37 / $111.20 / $220.00	Professional	TC	$103.37	$111.20	$220.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $536.95 / $536.95 / $536.95	Professional		$536.95	$536.95	$536.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $86.52 / $239.60 / $239.60	Professional	26	$86.52	$239.60	$239.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.23 / $263.23 / $263.23	Professional		$263.23	$263.23	$263.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $173.73 / $237.07 / $328.01	Professional	26	$173.73	$237.07	$328.01
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $243.63 / $332.12 / $510.73	Professional	TC	$243.63	$332.12	$510.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.66 / $129.66 / $129.66	Facility	26	$129.66	$129.66	$129.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $421.85 / $722.02 / $1,218.43	Professional		$421.85	$722.02	$1,218.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.05 / $175.94 / $324.45	Professional	26	$112.05	$175.94	$324.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $303.30 / $518.82 / $899.39	Professional	TC	$303.30	$518.82	$899.39
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $157.94 / $157.94 / $319.05	Facility	26	$157.94	$157.94	$319.05
Medcost Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $455.00 / $607.00	Professional		$153.00	$455.00	$607.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $157.94 / $157.94 / $157.94	Professional	26	$157.94	$157.94	$157.94
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $270.70 / $380.40 / $380.40	Professional	TC	$270.70	$380.40	$380.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $476.50 / $610.90 / $1,161.00	Professional		$476.50	$610.90	$1,161.00
United Facility/Professional Professional Modifier Low / Median / High Price $415.76 / $612.13 / $1,199.24	Professional		$415.76	$612.13	$1,199.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $111.35 / $167.50 / $319.02	Professional	26	$111.35	$167.50	$319.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $300.81 / $453.76 / $924.76	Professional	TC	$300.81	$453.76	$924.76
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $830.40 / $1,043.04 / $1,043.04	Facility	26	$830.40	$1,043.04	$1,043.04
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,850.25 / $1,850.25 / $1,992.01	Professional		$1,850.25	$1,850.25	$1,992.01
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $717.76 / $918.38 / $918.38	Professional	26	$717.76	$918.38	$918.38
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,344.20 / $1,344.20 / $1,492.96	Professional	TC	$1,344.20	$1,344.20	$1,492.96