Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.73 / $35.99 / $55.20	Facility	26	$29.73	$35.99	$55.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.44 / $165.09 / $418.77	Professional		$101.44	$165.09	$418.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.74 / $50.95 / $127.88	Professional	26	$29.74	$50.95	$127.88
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $50.72 / $53.19 / $249.00	Professional	52	$50.72	$53.19	$249.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.98 / $99.67 / $216.12	Professional	TC	$75.98	$99.67	$216.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.62 / $187.18 / $205.25	Professional		$87.62	$187.18	$205.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.44 / $47.02 / $69.19	Professional	26	$24.44	$47.02	$69.19
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $21.90 / $21.90 / $23.05	Professional	52	$21.90	$21.90	$23.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $60.20 / $145.31 / $182.90	Professional	TC	$60.20	$145.31	$182.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.28 / $206.28 / $229.40	Professional		$206.28	$206.28	$229.40
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.74 / $73.70 / $99.32	Professional	26	$46.74	$73.70	$99.32
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $88.22 / $128.36 / $232.81	Professional	TC	$88.22	$128.36	$232.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.42 / $37.42 / $37.42	Facility	26	$37.42	$37.42	$37.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.21 / $163.95 / $299.23	Professional		$100.21	$163.95	$299.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.58 / $50.03 / $89.15	Professional	26	$31.58	$50.03	$89.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.51 / $114.44 / $211.97	Professional	TC	$66.51	$114.44	$211.97
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $49.01 / $67.00 / $101.84	Facility	26	$49.01	$67.00	$101.84
Medcost Facility/Professional Professional Modifier Low / Median / High Price $44.00 / $135.00 / $432.25	Professional		$44.00	$135.00	$432.25
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $49.01 / $67.00 / $121.59	Professional	26	$49.01	$67.00	$121.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.08 / $113.03 / $181.87	Professional		$42.08	$113.03	$181.87
United Facility/Professional Professional Modifier Low / Median / High Price $98.41 / $155.57 / $316.19	Professional		$98.41	$155.57	$316.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.44 / $41.34 / $89.45	Professional	26	$30.44	$41.34	$89.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.27 / $98.84 / $193.00	Professional	TC	$69.27	$98.84	$193.00
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $161.36 / $161.36	Facility	26	$100.00	$161.36	$161.36
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $778.42 / $778.42 / $987.60	Professional		$778.42	$778.42	$987.60
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $290.60 / $290.60 / $290.60	Professional	26	$290.60	$290.60	$290.60
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $570.15 / $570.15 / $723.68	Professional	TC	$570.15	$570.15	$723.68