Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $124.60 / $189.68	Facility	26	$83.00	$124.60	$189.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $363.63 / $753.92	Professional		$275.00	$363.63	$753.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.37 / $112.19 / $327.20	Professional	26	$99.37	$112.19	$327.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.17 / $220.00 / $419.15	Professional	TC	$169.17	$220.00	$419.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.29 / $705.81 / $705.81	Professional		$309.29	$705.81	$705.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.99 / $172.74 / $235.55	Professional	26	$83.99	$172.74	$235.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $299.89 / $299.89 / $299.89	Professional		$299.89	$299.89	$299.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $185.94 / $262.11 / $343.95	Professional	26	$185.94	$262.11	$343.95
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $440.72 / $691.77 / $874.40	Professional	TC	$440.72	$691.77	$874.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.28 / $128.28 / $128.28	Facility	26	$128.28	$128.28	$128.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $485.79 / $825.65 / $1,388.90	Professional		$485.79	$825.65	$1,388.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.21 / $178.81 / $326.00	Professional	26	$111.21	$178.81	$326.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $335.20 / $623.91 / $1,053.91	Professional	TC	$335.20	$623.91	$1,053.91
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $175.26 / $197.00 / $313.64	Facility	26	$175.26	$197.00	$313.64
Medcost Facility/Professional Professional Modifier Low / Median / High Price $151.00 / $326.00 / $477.00	Professional		$151.00	$326.00	$477.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $175.26 / $175.26 / $412.86	Professional	26	$175.26	$175.26	$412.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $114.68 / $382.60 / $699.42	Professional		$114.68	$382.60	$699.42
United Facility/Professional Professional Modifier Low / Median / High Price $424.39 / $688.50 / $1,147.72	Professional		$424.39	$688.50	$1,147.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $116.21 / $159.53 / $314.33	Professional	26	$116.21	$159.53	$314.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $306.58 / $528.36 / $852.31	Professional	TC	$306.58	$528.36	$852.31
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $815.92 / $1,024.72 / $1,024.72	Facility	26	$815.92	$1,024.72	$1,024.72
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $4,801.00 / $4,801.00 / $4,801.00	Professional		$4,801.00	$4,801.00	$4,801.00
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $1,632.94 / $1,632.94 / $1,632.94	Professional	26	$1,632.94	$1,632.94	$1,632.94
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $3,601.00 / $3,601.00 / $3,601.00	Professional	TC	$3,601.00	$3,601.00	$3,601.00