Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.10 / $47.10 / $124.66	Facility	26	$47.10	$47.10	$124.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.34 / $193.83 / $363.48	Professional		$186.34	$193.83	$363.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.01 / $47.10 / $145.62	Professional	26	$45.01	$47.10	$145.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $139.25 / $150.59 / $284.06	Professional	TC	$139.25	$150.59	$284.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.16 / $75.16 / $75.16	Professional		$75.16	$75.16	$75.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.56 / $42.56 / $42.56	Professional	26	$42.56	$42.56	$42.56
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.69 / $126.11 / $164.65	Professional	26	$82.69	$126.11	$164.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $239.39 / $388.93 / $507.79	Professional	TC	$239.39	$388.93	$507.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.80 / $59.80 / $59.80	Facility	26	$59.80	$59.80	$59.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.19 / $380.71 / $618.85	Professional		$235.19	$380.71	$618.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.23 / $86.69 / $152.38	Professional	26	$57.23	$86.69	$152.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.39 / $287.27 / $470.05	Professional	TC	$177.39	$287.27	$470.05
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $61.11 / $82.86 / $146.69	Facility	26	$61.11	$82.86	$146.69
Medcost Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $261.00 / $761.94	Professional		$67.00	$261.00	$761.94
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $82.86 / $82.86 / $192.57	Professional	26	$82.86	$82.86	$192.57
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $255.54 / $255.54 / $255.54	Professional	TC	$255.54	$255.54	$255.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $580.50 / $580.50 / $580.50	Professional		$580.50	$580.50	$580.50
United Facility/Professional Professional Modifier Low / Median / High Price $221.91 / $300.05 / $610.25	Professional		$221.91	$300.05	$610.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.14 / $73.79 / $152.63	Professional	26	$54.14	$73.79	$152.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $166.41 / $226.67 / $456.64	Professional	TC	$166.41	$226.67	$456.64
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $122.98 / $254.79 / $254.79	Facility	26	$122.98	$254.79	$254.79
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,374.92 / $1,698.38 / $1,698.38	Professional		$1,374.92	$1,698.38	$1,698.38
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $330.16 / $417.45 / $417.45	Professional	26	$330.16	$417.45	$417.45
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,044.76 / $1,280.93 / $1,280.93	Professional	TC	$1,044.76	$1,280.93	$1,280.93