Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $119.64 / $188.83	Facility	26	$83.00	$119.64	$188.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.45 / $335.52 / $894.00	Professional		$275.45	$335.52	$894.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.31 / $123.97 / $370.22	Professional	26	$100.31	$123.97	$370.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.13 / $235.21 / $418.99	Professional	TC	$169.13	$235.21	$418.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $245.26 / $471.35 / $600.84	Professional		$245.26	$471.35	$600.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $84.72 / $149.44 / $225.84	Professional	26	$84.72	$149.44	$225.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $278.12 / $278.12 / $278.12	Professional		$278.12	$278.12	$278.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $178.00 / $253.52 / $318.18	Professional	26	$178.00	$253.52	$318.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $357.90 / $481.72 / $711.85	Professional	TC	$357.90	$481.72	$711.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.94 / $128.94 / $128.94	Facility	26	$128.94	$128.94	$128.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $428.30 / $759.56 / $1,248.55	Professional		$428.30	$759.56	$1,248.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.73 / $178.94 / $324.55	Professional	26	$118.73	$178.94	$324.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $284.22 / $549.98 / $962.70	Professional	TC	$284.22	$549.98	$962.70
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $165.87 / $166.88 / $311.85	Facility	26	$165.87	$166.88	$311.85
Medcost Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $376.00 / $526.00	Professional		$150.00	$376.00	$526.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $166.88 / $166.88 / $166.88	Professional	26	$166.88	$166.88	$166.88
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $373.35 / $373.35 / $622.40	Professional	TC	$373.35	$373.35	$622.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $116.44 / $307.60 / $540.92	Professional		$116.44	$307.60	$540.92
United Facility/Professional Professional Modifier Low / Median / High Price $365.59 / $656.09 / $1,049.32	Professional		$365.59	$656.09	$1,049.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $115.33 / $165.33 / $314.33	Professional	26	$115.33	$165.33	$314.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $231.98 / $464.91 / $743.43	Professional	TC	$231.98	$464.91	$743.43
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $822.80 / $1,034.56 / $1,034.56	Facility	26	$822.80	$1,034.56	$1,034.56
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,091.94 / $2,743.65 / $2,743.65	Professional		$2,091.94	$2,743.65	$2,743.65
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $711.82 / $908.70 / $908.70	Professional	26	$711.82	$908.70	$908.70
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,773.11 / $1,834.95 / $1,834.95	Professional	TC	$1,773.11	$1,834.95	$1,834.95