Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $57.54 / $147.91	Facility	26	$38.02	$57.54	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $102.33 / $398.11	Professional		$70.79	$102.33	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $51.29 / $147.91	Professional	26	$35.48	$51.29	$147.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $56.23 / $218.78	Professional	TC	$32.36	$56.23	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $57.54 / $107.15	Professional		$54.95	$57.54	$107.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $39.81 / $63.10	Professional	26	$28.84	$39.81	$63.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $30.90 / $30.90	Professional	TC	$30.90	$30.90	$30.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Professional		$102.33	$102.33	$102.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $79.43 / $109.65	Professional	26	$61.66	$79.43	$109.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $134.90 / $251.19	Professional	TC	$69.18	$134.90	$251.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.12 / $42.66 / $61.66	Facility	26	$9.12	$42.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $144.54 / $263.03	Professional		$69.18	$144.54	$263.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $57.54 / $102.33	Professional	26	$33.11	$57.54	$102.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $72.44 / $177.83	Professional	TC	$31.62	$72.44	$177.83
Medcost Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Professional		$288.40	$288.40	$288.40
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Professional	26	$74.13	$74.13	$74.13
Medcost Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $72.44 / $154.88	Professional		$38.02	$72.44	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $120.23 / $208.93	Professional		$69.18	$120.23	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $47.86 / $93.33	Professional	26	$36.31	$47.86	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $57.54 / $131.83	Professional	TC	$29.51	$57.54	$131.83
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $239.88 / $239.88 / $239.88	Facility	26	$239.88	$239.88	$239.88
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,000.00 / $1,000.00	Professional		$707.95	$1,000.00	$1,000.00
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $239.88 / $239.88 / $302.00	Professional	26	$239.88	$239.88	$302.00
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $549.54 / $776.25 / $776.25	Professional	TC	$549.54	$776.25	$776.25