Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.66 / $247.65 / $2,412.71	Facility		$162.66	$247.65	$2,412.71
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.99 / $73.70 / $88.56	Facility	26	$54.99	$73.70	$88.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.28 / $153.09 / $289.02	Professional		$79.28	$153.09	$289.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $73.70 / $175.49	Professional	26	$48.86	$73.70	$175.49
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $64.06 / $66.90 / $129.04	Professional	52	$64.06	$66.90	$129.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.08 / $77.68 / $226.26	Professional	TC	$60.08	$77.68	$226.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $116.40 / $116.40 / $116.40	Professional	26	$116.40	$116.40	$116.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.47 / $143.47 / $143.47	Professional		$143.47	$143.47	$143.47
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.41 / $118.60 / $194.00	Professional	26	$89.41	$118.60	$194.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.52 / $614.02 / $891.17	Professional	TC	$190.52	$614.02	$891.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.14 / $167.76 / $3,554.03	Facility		$100.14	$167.76	$3,554.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.06 / $94.06 / $94.06	Facility	26	$94.06	$94.06	$94.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.61 / $367.85 / $795.43	Professional		$167.61	$367.85	$795.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.09 / $104.88 / $198.21	Professional	26	$60.09	$104.88	$198.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.88 / $217.48 / $673.52	Professional	TC	$77.88	$217.48	$673.52
Medcost Facility/Professional Facility Modifier Low / Median / High Price $133.79 / $403.31 / $846.00	Facility		$133.79	$403.31	$846.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $82.38 / $95.00 / $204.75	Facility	26	$82.38	$95.00	$204.75
Medcost Facility/Professional Professional Modifier Low / Median / High Price $71.00 / $132.00 / $204.00	Professional		$71.00	$132.00	$204.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $82.38 / $95.00 / $301.36	Professional	26	$82.38	$95.00	$301.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $99.08 / $207.82 / $397.20	Professional		$99.08	$207.82	$397.20
United Facility/Professional Professional Modifier Low / Median / High Price $158.74 / $294.55 / $470.19	Professional		$158.74	$294.55	$470.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.89 / $100.25 / $182.00	Professional	26	$57.89	$100.25	$182.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.89 / $142.54 / $398.69	Professional	TC	$74.89	$142.54	$398.69
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $883.12 / $1,600.36 / $1,600.36	Facility		$883.12	$1,600.36	$1,600.36
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $188.75 / $386.03 / $386.03	Facility	26	$188.75	$386.03	$386.03
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,195.57 / $3,195.57 / $3,195.57	Professional		$3,195.57	$3,195.57	$3,195.57
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $551.37 / $551.37 / $667.80	Professional	26	$551.37	$551.37	$667.80
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