Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.34 / $72.45 / $126.00	Facility	26	$68.34	$72.45	$126.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.39 / $350.41 / $655.39	Professional		$202.39	$350.41	$655.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.56 / $77.81 / $197.76	Professional	26	$67.56	$77.81	$197.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.04 / $151.72 / $373.11	Professional	TC	$134.04	$151.72	$373.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $123.61 / $123.61 / $158.91	Professional	26	$123.61	$123.61	$158.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $222.33 / $222.33 / $222.33	Professional	TC	$222.33	$222.33	$222.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.07 / $181.98 / $237.59	Professional	26	$120.07	$181.98	$237.59
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $232.19 / $377.45 / $492.80	Professional	TC	$232.19	$377.45	$492.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.45 / $86.45 / $86.45	Facility	26	$86.45	$86.45	$86.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.55 / $413.62 / $671.42	Professional		$255.55	$413.62	$671.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.50 / $125.10 / $218.94	Professional	26	$82.50	$125.10	$218.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.15 / $278.79 / $452.79	Professional	TC	$172.15	$278.79	$452.79
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $88.60 / $119.56 / $212.69	Facility	26	$88.60	$119.56	$212.69
Medcost Facility/Professional Professional Modifier Low / Median / High Price $97.00 / $286.00 / $827.56	Professional		$97.00	$286.00	$827.56
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $119.56 / $119.56 / $279.45	Professional	26	$119.56	$119.56	$279.45
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $248.00 / $248.00 / $248.00	Professional	TC	$248.00	$248.00	$248.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $76.06 / $204.87 / $358.32	Professional		$76.06	$204.87	$358.32
United Facility/Professional Professional Modifier Low / Median / High Price $247.84 / $593.25 / $1,356.12	Professional		$247.84	$593.25	$1,356.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.12 / $111.77 / $221.42	Professional	26	$78.12	$111.77	$221.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.02 / $441.30 / $1,144.10	Professional	TC	$162.02	$441.30	$1,144.10
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $549.04 / $691.52 / $691.52	Facility	26	$549.04	$691.52	$691.52
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,484.56 / $1,852.58 / $1,852.58	Professional		$1,484.56	$1,852.58	$1,852.58
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $478.82 / $605.54 / $605.54	Professional	26	$478.82	$605.54	$605.54
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,005.68 / $1,247.03 / $1,247.03	Professional	TC	$1,005.68	$1,247.03	$1,247.03