Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.34 / $82.61 / $101.01	Facility	26	$66.34	$82.61	$101.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.68 / $166.23 / $381.72	Professional		$144.68	$166.23	$381.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.82 / $82.61 / $183.49	Professional	26	$56.82	$82.61	$183.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.07 / $75.98 / $250.48	Professional	TC	$62.07	$75.98	$250.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $68.41 / $68.41 / $164.86	Professional	26	$68.41	$68.41	$164.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.68 / $163.68 / $163.68	Professional		$163.68	$163.68	$163.68
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $101.94 / $136.27 / $219.28	Professional	26	$101.94	$136.27	$219.28
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $219.68 / $385.76 / $938.26	Professional	TC	$219.68	$385.76	$938.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.26 / $105.26 / $105.26	Facility	26	$105.26	$105.26	$105.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $180.56 / $413.32 / $847.84	Professional		$180.56	$413.32	$847.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.14 / $119.40 / $221.87	Professional	26	$68.14	$119.40	$221.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.68 / $243.85 / $708.67	Professional	TC	$79.68	$243.85	$708.67
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $95.70 / $108.00 / $235.00	Facility	26	$95.70	$108.00	$235.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $152.00 / $233.00	Professional		$81.00	$152.00	$233.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $95.70 / $95.70 / $108.00	Professional	26	$95.70	$95.70	$108.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $253.81 / $253.81 / $253.81	Professional	TC	$253.81	$253.81	$253.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $103.40 / $226.16 / $463.90	Professional		$103.40	$226.16	$463.90
United Facility/Professional Professional Modifier Low / Median / High Price $169.47 / $319.02 / $560.54	Professional		$169.47	$319.02	$560.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.48 / $113.70 / $196.13	Professional	26	$65.48	$113.70	$196.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.45 / $167.94 / $488.50	Professional	TC	$76.45	$167.94	$488.50
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $213.91 / $438.57 / $438.57	Facility	26	$213.91	$438.57	$438.57
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,234.28 / $3,234.28 / $3,234.28	Professional		$3,234.28	$3,234.28	$3,234.28
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $681.88 / $681.88 / $748.95	Professional	26	$681.88	$681.88	$748.95
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