Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.60 / $33.67 / $51.26	Facility	26	$27.60	$33.67	$51.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.14 / $126.03 / $582.00	Professional		$86.14	$126.03	$582.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.60 / $44.28 / $136.21	Professional	26	$27.60	$44.28	$136.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.53 / $93.73 / $154.38	Professional	TC	$61.53	$93.73	$154.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.54 / $97.92 / $246.76	Professional		$72.54	$97.92	$246.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.43 / $28.29 / $63.54	Professional	26	$22.43	$28.29	$63.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.59 / $74.52 / $100.20	Professional	TC	$44.59	$74.52	$100.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.30 / $80.30 / $80.30	Professional		$80.30	$80.30	$80.30
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.92 / $68.28 / $92.32	Professional	26	$42.92	$68.28	$92.32
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.22 / $138.91 / $216.77	Professional	TC	$95.22	$138.91	$216.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $34.36 / $34.36	Facility	26	$34.36	$34.36	$34.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.60 / $136.18 / $245.63	Professional		$87.60	$136.18	$245.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.34 / $47.16 / $80.22	Professional	26	$29.34	$47.16	$80.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.34 / $86.24 / $172.30	Professional	TC	$55.34	$86.24	$172.30
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $46.22 / $53.00 / $84.22	Facility	26	$46.22	$53.00	$84.22
Medcost Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $86.00 / $364.43	Professional		$41.00	$86.00	$364.43
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $46.22 / $53.00 / $112.87	Professional	26	$46.22	$53.00	$112.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.64 / $95.83 / $168.02	Professional		$31.64	$95.83	$168.02
United Facility/Professional Professional Modifier Low / Median / High Price $89.22 / $120.85 / $224.58	Professional		$89.22	$120.85	$224.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.80 / $39.10 / $83.15	Professional	26	$28.80	$39.10	$83.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.89 / $81.55 / $148.88	Professional	TC	$57.89	$81.55	$148.88
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $85.90 / $147.82 / $147.82	Facility	26	$85.90	$147.82	$147.82
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $654.87 / $654.87 / $836.03	Professional		$654.87	$654.87	$836.03
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $217.94 / $217.94 / $242.48	Professional	26	$217.94	$217.94	$242.48
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $461.63 / $461.63 / $593.54	Professional	TC	$461.63	$461.63	$593.54