Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.42 / $60.36 / $88.03	Facility	26	$54.42	$60.36	$88.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.93 / $155.50 / $271.14	Professional		$112.93	$155.50	$271.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.65 / $61.58 / $190.00	Professional	26	$49.65	$61.58	$190.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.57 / $64.86 / $187.06	Professional	TC	$52.57	$64.86	$187.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $94.60 / $94.60 / $94.60	Professional	26	$94.60	$94.60	$94.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.90 / $142.90 / $142.90	Professional		$142.90	$142.90	$142.90
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.83 / $118.43 / $159.54	Professional	26	$88.83	$118.43	$159.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $180.29 / $600.70 / $873.17	Professional	TC	$180.29	$600.70	$873.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.09 / $77.09 / $77.09	Facility	26	$77.09	$77.09	$77.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.83 / $329.11 / $771.56	Professional		$143.83	$329.11	$771.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.53 / $97.03 / $162.13	Professional	26	$56.53	$97.03	$162.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.95 / $177.71 / $684.70	Professional	TC	$67.95	$177.71	$684.70
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $83.75 / $111.00 / $357.00	Facility	26	$83.75	$111.00	$357.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $101.00 / $172.00	Professional		$70.00	$101.00	$172.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $83.75 / $111.00 / $246.78	Professional	26	$83.75	$111.00	$246.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $203.30 / $299.89 / $727.40	Professional		$203.30	$299.89	$727.40
United Facility/Professional Professional Modifier Low / Median / High Price $134.02 / $244.64 / $450.10	Professional		$134.02	$244.64	$450.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.27 / $83.17 / $144.01	Professional	26	$56.27	$83.17	$144.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.78 / $125.37 / $392.75	Professional	TC	$67.78	$125.37	$392.75
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $155.03 / $317.02 / $317.02	Facility	26	$155.03	$317.02	$317.02
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,190.96 / $3,190.96 / $3,190.96	Professional		$3,190.96	$3,190.96	$3,190.96
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $636.41 / $636.41 / $636.41	Professional	26	$636.41	$636.41	$636.41
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,892.33 / $2,892.33 / $2,892.33	Professional	TC	$2,892.33	$2,892.33	$2,892.33