Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.73 / $90.62 / $137.94	Facility	26	$82.73	$90.62	$137.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.99 / $275.00 / $586.50	Professional		$229.99	$275.00	$586.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.00 / $82.74 / $237.78	Professional	26	$73.00	$82.74	$237.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.25 / $191.62 / $299.94	Professional	TC	$147.25	$191.62	$299.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $326.33 / $326.33 / $415.99	Professional		$326.33	$326.33	$415.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.14 / $99.68 / $151.24	Professional	26	$62.14	$99.68	$151.24
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $124.21 / $124.21 / $124.21	Professional	TC	$124.21	$124.21	$124.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.88 / $203.88 / $203.88	Professional		$203.88	$203.88	$203.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $132.36 / $194.28 / $233.23	Professional	26	$132.36	$194.28	$233.23
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $271.33 / $363.43 / $516.12	Professional	TC	$271.33	$363.43	$516.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.84 / $93.84 / $93.84	Facility	26	$93.84	$93.84	$93.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.86 / $443.96 / $738.40	Professional		$263.86	$443.96	$738.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.96 / $131.90 / $237.10	Professional	26	$86.96	$131.90	$237.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.59 / $285.68 / $495.20	Professional	TC	$172.59	$285.68	$495.20
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $122.33 / $122.33 / $229.12	Facility	26	$122.33	$122.33	$229.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $245.00 / $355.00	Professional		$110.00	$245.00	$355.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $122.33 / $122.33 / $122.33	Professional	26	$122.33	$122.33	$122.33
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $541.88 / $541.88 / $541.88	Professional	TC	$541.88	$541.88	$541.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.69 / $218.94 / $381.13	Professional		$83.69	$218.94	$381.13
United Facility/Professional Professional Modifier Low / Median / High Price $250.62 / $372.82 / $716.04	Professional		$250.62	$372.82	$716.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.94 / $112.53 / $231.47	Professional	26	$82.94	$112.53	$231.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $152.59 / $257.20 / $481.12	Professional	TC	$152.59	$257.20	$481.12
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $595.28 / $750.32 / $750.32	Facility	26	$595.28	$750.32	$750.32
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,515.48 / $1,932.15 / $1,932.15	Professional		$1,515.48	$1,932.15	$1,932.15
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $521.79 / $655.65 / $655.65	Professional	26	$521.79	$655.65	$655.65
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $993.68 / $1,276.50 / $1,276.50	Professional	TC	$993.68	$1,276.50	$1,276.50