Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.74 / $41.67 / $69.92	Facility	26	$36.74	$41.67	$69.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.11 / $181.27 / $468.00	Professional		$95.11	$181.27	$468.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.61 / $68.94 / $210.00	Professional	26	$36.61	$68.94	$210.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.82 / $64.31 / $163.98	Professional	TC	$56.82	$64.31	$163.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.09 / $148.74 / $193.59	Professional		$103.09	$148.74	$193.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.21 / $54.76 / $81.45	Professional	26	$30.21	$54.76	$81.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $82.78 / $101.18 / $116.11	Professional	TC	$82.78	$101.18	$116.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.30 / $108.30 / $108.30	Professional		$108.30	$108.30	$108.30
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.12 / $83.52 / $122.05	Professional	26	$55.12	$83.52	$122.05
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.81 / $118.75 / $191.62	Professional	TC	$77.81	$118.75	$191.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.25 / $46.25 / $46.25	Facility	26	$46.25	$46.25	$46.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.65 / $152.55 / $282.87	Professional		$93.65	$152.55	$282.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.79 / $61.24 / $111.25	Professional	26	$38.79	$61.24	$111.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.20 / $93.62 / $171.62	Professional	TC	$50.20	$93.62	$171.62
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $59.93 / $72.00 / $99.61	Facility	26	$59.93	$72.00	$99.61
Medcost Facility/Professional Professional Modifier Low / Median / High Price $52.00 / $106.00 / $395.93	Professional		$52.00	$106.00	$395.93
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $59.93 / $59.93 / $72.00	Professional	26	$59.93	$59.93	$72.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $245.68 / $245.68 / $245.68	Professional	TC	$245.68	$245.68	$245.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.17 / $95.39 / $176.40	Professional		$41.17	$95.39	$176.40
United Facility/Professional Professional Modifier Low / Median / High Price $92.62 / $130.75 / $281.04	Professional		$92.62	$130.75	$281.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.96 / $51.09 / $109.68	Professional	26	$38.96	$51.09	$109.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.41 / $80.06 / $161.36	Professional	TC	$53.41	$80.06	$161.36
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $95.69 / $198.74 / $198.74	Facility	26	$95.69	$198.74	$198.74
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $708.49 / $708.49 / $902.10	Professional		$708.49	$708.49	$902.10
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $257.68 / $257.68 / $321.00	Professional	26	$257.68	$257.68	$321.00
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $450.80 / $450.80 / $581.10	Professional	TC	$450.80	$450.80	$581.10