Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $125.89 / $281.84	Facility	26	$83.18	$125.89	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $295.12 / $831.76	Professional		$223.87	$295.12	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $109.65 / $302.00	Professional	26	$72.44	$109.65	$302.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $199.53 / $371.54	Professional	TC	$141.25	$199.53	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $426.58	Professional		$331.13	$331.13	$426.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $117.49 / $138.04	Professional	26	$75.86	$117.49	$138.04
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	TC	$123.03	$123.03	$123.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $194.98 / $234.42	Professional	26	$125.89	$194.98	$234.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $346.74 / $512.86	Professional	TC	$257.04	$346.74	$512.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $93.33 / $134.90	Facility	26	$19.95	$93.33	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $389.05 / $724.44	Professional		$257.04	$389.05	$724.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $125.89 / $229.09	Professional	26	$72.44	$125.89	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $263.03 / $478.63	Professional	TC	$169.82	$263.03	$478.63
Medcost Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Professional		$416.87	$416.87	$416.87
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $147.91 / $147.91	Professional	26	$147.91	$147.91	$147.91
Medcost Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Professional		$263.03	$263.03	$263.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $218.78 / $512.86	Professional		$83.18	$218.78	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $338.84 / $616.60	Professional		$239.88	$338.84	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $107.15 / $199.53	Professional	26	$81.28	$107.15	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $234.42 / $416.87	Professional	TC	$154.88	$234.42	$416.87
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $758.58 / $758.58 / $758.58	Facility	26	$758.58	$758.58	$758.58
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,949.84	Professional		$1,513.56	$1,513.56	$1,949.84
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $524.81 / $524.81 / $660.69	Professional	26	$524.81	$524.81	$660.69
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,000.00 / $1,000.00 / $1,288.25	Professional	TC	$1,000.00	$1,000.00	$1,288.25