Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.75 / $29.81 / $66.91	Facility	26	$25.75	$29.81	$66.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.62 / $106.50 / $194.14	Professional		$91.62	$106.50	$194.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.50 / $27.05 / $69.78	Professional	26	$24.50	$27.05	$69.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.11 / $71.89 / $133.91	Professional	TC	$65.11	$71.89	$133.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.75 / $179.70 / $253.65	Professional		$76.75	$179.70	$253.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.13 / $23.29 / $59.90	Professional	26	$21.13	$23.29	$59.90
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.51 / $61.02 / $88.08	Professional	26	$41.51	$61.02	$88.08
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.41 / $151.18 / $218.02	Professional	TC	$95.41	$151.18	$218.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $32.36 / $32.36	Facility	26	$32.36	$32.36	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.44 / $155.75 / $263.83	Professional		$105.44	$155.75	$263.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $44.30 / $75.95	Professional	26	$30.20	$44.30	$75.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.80 / $110.80 / $189.81	Professional	TC	$74.80	$110.80	$189.81
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $44.47 / $50.12 / $79.73	Facility	26	$44.47	$50.12	$79.73
Medcost Facility/Professional Professional Modifier Low / Median / High Price $37.00 / $154.56 / $374.62	Professional		$37.00	$154.56	$374.62
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $105.32 / $105.32 / $105.32	Professional	26	$105.32	$105.32	$105.32
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $110.09 / $110.09 / $110.09	Professional	TC	$110.09	$110.09	$110.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.96 / $125.90 / $284.39	Professional		$39.96	$125.90	$284.39
United Facility/Professional Professional Modifier Low / Median / High Price $102.04 / $142.63 / $268.98	Professional		$102.04	$142.63	$268.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.98 / $38.54 / $77.58	Professional	26	$28.98	$38.54	$77.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.59 / $94.04 / $191.06	Professional	TC	$72.59	$94.04	$191.06
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $67.03 / $139.84 / $139.84	Facility	26	$67.03	$139.84	$139.84
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $674.54 / $888.15 / $888.15	Professional		$674.54	$888.15	$888.15
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $180.38 / $229.58 / $229.58	Professional	26	$180.38	$229.58	$229.58
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $494.15 / $658.65 / $658.65	Professional	TC	$494.15	$658.65	$658.65