Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $83.18 / $177.83	Facility	26	$69.18	$83.18	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $562.34	Professional		$131.83	$177.83	$562.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $95.50 / $245.47	Professional	26	$56.23	$95.50	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $109.65 / $239.88	Professional	TC	$67.61	$109.65	$239.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $114.82	Professional	26	$52.48	$72.44	$114.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Professional		$134.90	$134.90	$134.90
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $125.89 / $162.18	Professional	26	$83.18	$125.89	$162.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $281.84 / $512.86	Professional	TC	$134.90	$281.84	$512.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $112.20	Facility	26	$16.98	$79.43	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $269.15 / $446.68	Professional		$123.03	$269.15	$446.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $91.20 / $173.78	Professional	26	$56.23	$91.20	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $141.25 / $354.81	Professional	TC	$60.26	$141.25	$354.81
Medcost Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Professional		$245.47	$245.47	$245.47
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Professional	26	$100.00	$100.00	$100.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Professional		$144.54	$144.54	$144.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $120.23 / $323.59	Professional		$56.23	$120.23	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $208.93 / $363.08	Professional		$131.83	$208.93	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $75.86 / $147.91	Professional	26	$54.95	$75.86	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $112.20 / $251.19	Professional	TC	$67.61	$112.20	$251.19
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $630.96 / $630.96 / $630.96	Facility	26	$630.96	$630.96	$630.96
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Professional		$1,445.44	$1,445.44	$1,445.44
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $436.52 / $436.52 / $549.54	Professional	26	$436.52	$436.52	$549.54
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Professional	TC	$1,174.90	$1,174.90	$1,174.90