Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.94 / $54.50 / $388.50	Facility	26	$28.94	$54.50	$388.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.48 / $159.87 / $367.04	Professional		$118.48	$159.87	$367.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.94 / $33.97 / $93.05	Professional	26	$28.94	$33.97	$93.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.42 / $92.74 / $189.78	Professional	TC	$84.42	$92.74	$189.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $142.19 / $156.11 / $308.16	Professional		$142.19	$156.11	$308.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.19 / $47.30 / $64.16	Professional	26	$24.19	$47.30	$64.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $87.28	Professional		$87.28	$87.28	$87.28
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.96 / $69.01 / $98.33	Professional	26	$45.96	$69.01	$98.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.28 / $157.06 / $224.72	Professional	TC	$89.28	$157.06	$224.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.04 / $37.04 / $37.04	Facility	26	$37.04	$37.04	$37.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.64 / $192.49 / $385.75	Professional		$120.64	$192.49	$385.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.09 / $49.20 / $85.99	Professional	26	$32.09	$49.20	$85.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.72 / $139.66 / $319.08	Professional	TC	$80.72	$139.66	$319.08
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $50.85 / $57.00 / $85.57	Facility	26	$50.85	$57.00	$85.57
Medcost Facility/Professional Professional Modifier Low / Median / High Price $42.00 / $120.00 / $497.54	Professional		$42.00	$120.00	$497.54
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $50.85 / $50.85 / $57.00	Professional	26	$50.85	$50.85	$57.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $379.22 / $379.22 / $379.22	Professional	TC	$379.22	$379.22	$379.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $48.46 / $146.30 / $292.02	Professional		$48.46	$146.30	$292.02
United Facility/Professional Professional Modifier Low / Median / High Price $109.15 / $159.88 / $335.04	Professional		$109.15	$159.88	$335.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.30 / $43.17 / $88.73	Professional	26	$31.30	$43.17	$88.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.28 / $119.03 / $260.33	Professional	TC	$78.28	$119.03	$260.33
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $158.46 / $158.46	Facility	26	$100.00	$158.46	$158.46
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $898.89 / $898.89 / $1,186.05	Professional		$898.89	$898.89	$1,186.05
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $371.50 / $371.50 / $371.50	Professional	26	$371.50	$371.50	$371.50
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $695.99 / $695.99 / $929.03	Professional	TC	$695.99	$695.99	$929.03