Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.35 / $134.05 / $205.56	Facility	26	$122.35	$134.05	$205.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $378.23 / $475.00 / $1,209.11	Professional		$378.23	$475.00	$1,209.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $119.21 / $155.65 / $440.25	Professional	26	$119.21	$155.65	$440.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $255.88 / $335.00 / $601.02	Professional	TC	$255.88	$335.00	$601.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $700.52	Professional		$549.54	$549.54	$700.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $91.55 / $221.28 / $309.14	Professional	26	$91.55	$221.28	$309.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.08 / $316.08 / $316.08	Professional		$316.08	$316.08	$316.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $208.61 / $307.94 / $371.34	Professional	26	$208.61	$307.94	$371.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $630.10 / $936.89 / $1,345.89	Professional	TC	$630.10	$936.89	$1,345.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $139.38 / $139.38 / $139.38	Facility	26	$139.38	$139.38	$139.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $460.12 / $845.18 / $1,518.17	Professional		$460.12	$845.18	$1,518.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.58 / $206.37 / $352.00	Professional	26	$124.58	$206.37	$352.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $313.47 / $627.13 / $1,197.19	Professional	TC	$313.47	$627.13	$1,197.19
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $192.45 / $214.93 / $326.39	Facility	26	$192.45	$214.93	$326.39
Medcost Facility/Professional Professional Modifier Low / Median / High Price $162.00 / $369.00 / $531.00	Professional		$162.00	$369.00	$531.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $192.45 / $192.45 / $192.45	Professional	26	$192.45	$192.45	$192.45
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $808.49 / $941.64 / $941.64	Professional	TC	$808.49	$941.64	$941.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $121.42 / $638.73 / $1,044.20	Professional		$121.42	$638.73	$1,044.20
United Facility/Professional Professional Modifier Low / Median / High Price $404.61 / $697.53 / $1,205.04	Professional		$404.61	$697.53	$1,205.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $124.70 / $169.23 / $349.72	Professional	26	$124.70	$169.23	$349.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $276.02 / $523.32 / $796.73	Professional	TC	$276.02	$523.32	$796.73
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $888.48 / $1,118.24 / $1,118.24	Facility	26	$888.48	$1,118.24	$1,118.24
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $4,036.70 / $4,036.70 / $4,036.70	Professional		$4,036.70	$4,036.70	$4,036.70
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $771.93 / $980.18 / $980.18	Professional	26	$771.93	$980.18	$980.18
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $3,390.79 / $3,390.79 / $3,390.79	Professional	TC	$3,390.79	$3,390.79	$3,390.79