Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.73 / $74.06 / $96.90	Facility	26	$59.73	$74.06	$96.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.84 / $152.38 / $340.53	Professional		$139.84	$152.38	$340.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.54 / $69.88 / $203.14	Professional	26	$52.54	$69.88	$203.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.97 / $97.59 / $220.00	Professional	TC	$69.97	$97.59	$220.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.49 / $100.61 / $168.00	Professional	26	$52.49	$100.61	$168.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.85 / $133.85 / $133.85	Professional		$133.85	$133.85	$133.85
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.34 / $125.65 / $161.54	Professional	26	$88.34	$125.65	$161.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $146.58 / $281.00 / $513.87	Professional	TC	$146.58	$281.00	$513.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.31 / $79.31 / $79.31	Facility	26	$79.31	$79.31	$79.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.52 / $293.08 / $449.84	Professional		$156.52	$293.08	$449.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.96 / $97.42 / $171.06	Professional	26	$58.96	$97.42	$171.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.56 / $159.66 / $363.07	Professional	TC	$77.56	$159.66	$363.07
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $73.13 / $83.09 / $194.56	Facility	26	$73.13	$83.09	$194.56
Medcost Facility/Professional Professional Modifier Low / Median / High Price $72.00 / $83.00 / $238.64	Professional		$72.00	$83.00	$238.64
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $83.09 / $83.09 / $83.09	Professional	26	$83.09	$83.09	$83.09
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $257.49 / $257.49 / $385.89	Professional	TC	$257.49	$257.49	$385.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.02 / $117.15 / $236.20	Professional		$64.02	$117.15	$236.20
United Facility/Professional Professional Modifier Low / Median / High Price $138.80 / $237.52 / $401.21	Professional		$138.80	$237.52	$401.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.68 / $83.37 / $171.10	Professional	26	$55.68	$83.37	$171.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.43 / $122.30 / $252.08	Professional	TC	$72.43	$122.30	$252.08
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $503.20 / $632.16 / $632.16	Facility	26	$503.20	$632.16	$632.16
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,448.59 / $1,448.59 / $1,448.59	Professional		$1,448.59	$1,448.59	$1,448.59
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $439.49 / $555.45 / $555.45	Professional	26	$439.49	$555.45	$555.45
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,174.23 / $1,174.23 / $1,174.23	Professional	TC	$1,174.23	$1,174.23	$1,174.23