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 $87.03 / $125.82 / $440.64	Professional		$87.03	$125.82	$440.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.32 / $46.92 / $127.88	Professional	26	$29.32	$46.92	$127.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.84 / $94.28 / $180.21	Professional	TC	$63.84	$94.28	$180.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.75 / $132.82 / $183.93	Professional		$77.75	$132.82	$183.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.17 / $36.99 / $68.51	Professional	26	$24.17	$36.99	$68.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.22 / $51.86 / $55.11	Professional	TC	$51.22	$51.86	$55.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.96 / $206.96 / $229.75	Professional		$206.96	$206.96	$229.75
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.28 / $73.01 / $99.32	Professional	26	$46.28	$73.01	$99.32
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.06 / $155.65 / $227.33	Professional	TC	$100.06	$155.65	$227.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.07 / $37.07 / $37.07	Facility	26	$37.07	$37.07	$37.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.71 / $153.41 / $283.88	Professional		$99.71	$153.41	$283.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.58 / $50.87 / $86.89	Professional	26	$31.58	$50.87	$86.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.28 / $103.08 / $189.82	Professional	TC	$61.28	$103.08	$189.82
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $49.85 / $67.00 / $92.10	Facility	26	$49.85	$67.00	$92.10
Medcost Facility/Professional Professional Modifier Low / Median / High Price $44.00 / $135.00 / $382.65	Professional		$44.00	$135.00	$382.65
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $49.85 / $49.85 / $67.00	Professional	26	$49.85	$49.85	$67.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $261.06 / $261.06 / $261.06	Professional	TC	$261.06	$261.06	$261.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.78 / $99.93 / $167.68	Professional		$41.78	$99.93	$167.68
United Facility/Professional Professional Modifier Low / Median / High Price $98.45 / $136.46 / $293.92	Professional		$98.45	$136.46	$293.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.64 / $43.63 / $88.91	Professional	26	$30.64	$43.63	$88.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.84 / $94.04 / $210.60	Professional	TC	$63.84	$94.04	$210.60
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $98.17 / $159.51 / $171.00	Facility	26	$98.17	$159.51	$171.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $687.27 / $687.27 / $877.28	Professional		$687.27	$687.27	$877.28
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $254.27 / $254.27 / $261.08	Professional	26	$254.27	$254.27	$261.08
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $479.00 / $479.00 / $616.20	Professional	TC	$479.00	$479.00	$616.20