Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.25 / $52.34 / $79.68	Facility	26	$42.25	$52.34	$79.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.79 / $203.33 / $506.20	Professional		$103.79	$203.33	$506.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.25 / $72.81 / $178.04	Professional	26	$42.25	$72.81	$178.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.53 / $84.76 / $191.44	Professional	TC	$61.53	$84.76	$191.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.93 / $160.91 / $209.20	Professional		$95.93	$160.91	$209.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.17 / $62.99 / $88.83	Professional	26	$35.17	$62.99	$88.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $103.16 / $103.16 / $103.16	Professional	TC	$103.16	$103.16	$103.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.70 / $125.70 / $125.70	Professional		$125.70	$125.70	$125.70
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.83 / $105.98 / $140.59	Professional	26	$66.83	$105.98	$140.59
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.03 / $156.19 / $213.51	Professional	TC	$100.03	$156.19	$213.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.62 / $53.62 / $53.62	Facility	26	$53.62	$53.62	$53.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.57 / $179.14 / $316.07	Professional		$119.57	$179.14	$316.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.73 / $71.79 / $129.80	Professional	26	$44.73	$71.79	$129.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.83 / $108.98 / $186.79	Professional	TC	$71.83	$108.98	$186.79
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $70.64 / $83.00 / $120.80	Facility	26	$70.64	$83.00	$120.80
Medcost Facility/Professional Professional Modifier Low / Median / High Price $64.00 / $150.00 / $424.38	Professional		$64.00	$150.00	$424.38
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $70.64 / $83.00 / $172.81	Professional	26	$70.64	$83.00	$172.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.10 / $102.10 / $187.64	Professional		$47.10	$102.10	$187.64
United Facility/Professional Professional Modifier Low / Median / High Price $116.34 / $141.50 / $302.62	Professional		$116.34	$141.50	$302.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.91 / $62.46 / $124.50	Professional	26	$43.91	$62.46	$124.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.41 / $92.54 / $182.77	Professional	TC	$68.41	$92.54	$182.77
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $111.13 / $230.61 / $230.61	Facility	26	$111.13	$230.61	$230.61
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $757.96 / $757.96 / $968.93	Professional		$757.96	$757.96	$968.93
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $322.45 / $322.45 / $376.50	Professional	26	$322.45	$322.45	$376.50
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $484.95 / $484.95 / $592.35	Professional	TC	$484.95	$484.95	$592.35