Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.58 / $290.45 / $617.91	Facility		$92.58	$290.45	$617.91
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.71 / $17.22 / $26.21	Facility	26	$13.71	$17.22	$26.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $92.58 / $187.55	Professional		$81.59	$92.58	$187.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.64 / $15.03 / $44.08	Professional	26	$13.64	$15.03	$44.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.40 / $78.87 / $151.15	Professional	TC	$67.40	$78.87	$151.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $20.85 / $28.25	Professional	26	$11.72	$20.85	$28.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.52 / $41.52 / $41.52	Professional		$41.52	$41.52	$41.52
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.99 / $35.71 / $46.29	Professional	26	$25.99	$35.71	$46.29
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $96.27 / $138.94 / $189.88	Professional	TC	$96.27	$138.94	$189.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.32 / $175.27 / $296.76	Facility		$116.32	$175.27	$296.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.75 / $17.75 / $17.75	Facility	26	$17.75	$17.75	$17.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.13 / $134.37 / $247.44	Professional		$82.13	$134.37	$247.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.47 / $25.61 / $44.51	Professional	26	$15.47	$25.61	$44.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.14 / $110.33 / $204.15	Professional	TC	$64.14	$110.33	$204.15
Medcost Facility/Professional Facility Modifier Low / Median / High Price $92.58 / $122.00 / $227.77	Facility		$92.58	$122.00	$227.77
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $24.56 / $28.00 / $50.54	Facility	26	$24.56	$28.00	$50.54
Medcost Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $81.00 / $119.52	Professional		$21.00	$81.00	$119.52
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $24.56 / $28.00 / $56.08	Professional	26	$24.56	$28.00	$56.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $16.03 / $97.95 / $175.57	Professional		$16.03	$97.95	$175.57
United Facility/Professional Facility Modifier Low / Median / High Price $18.89 / $87.89 / $254.04	Facility		$18.89	$87.89	$254.04
United Facility/Professional Professional Modifier Low / Median / High Price $81.39 / $119.41 / $210.24	Professional		$81.39	$119.41	$210.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.98 / $21.49 / $40.59	Professional	26	$15.98	$21.49	$40.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.76 / $91.75 / $172.50	Professional	TC	$64.76	$91.75	$172.50
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $216.57 / $548.44 / $548.44	Facility		$216.57	$548.44	$548.44
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $53.99 / $100.00 / $100.00	Facility	26	$53.99	$100.00	$100.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $687.89 / $687.89 / $854.25	Professional		$687.89	$687.89	$854.25
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	26	$150.00	$150.00	$150.00
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $591.79 / $591.79 / $731.03	Professional	TC	$591.79	$591.79	$731.03