Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.14 / $104.02 / $176.68	Facility	26	$98.14	$104.02	$176.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.02 / $475.00 / $1,320.50	Professional		$318.02	$475.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.14 / $140.00 / $356.41	Professional	26	$98.14	$140.00	$356.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $219.88 / $259.62 / $598.94	Professional	TC	$219.88	$259.62	$598.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $258.97 / $710.91 / $710.91	Professional		$258.97	$710.91	$710.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.64 / $117.69 / $229.61	Professional	26	$81.64	$117.69	$229.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $171.13 / $171.13 / $601.25	Professional	TC	$171.13	$171.13	$601.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $176.68 / $249.74 / $339.28	Professional	26	$176.68	$249.74	$339.28
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $422.55 / $552.04 / $811.40	Professional	TC	$422.55	$552.04	$811.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.62 / $124.62 / $124.62	Facility	26	$124.62	$124.62	$124.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $403.12 / $652.53 / $1,059.28	Professional		$403.12	$652.53	$1,059.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.08 / $178.90 / $314.52	Professional	26	$118.08	$178.90	$314.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $282.49 / $459.71 / $746.62	Professional	TC	$282.49	$459.71	$746.62
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $170.98 / $181.39 / $305.76	Facility	26	$170.98	$181.39	$305.76
Medcost Facility/Professional Professional Modifier Low / Median / High Price $141.00 / $448.00 / $1,300.35	Professional		$141.00	$448.00	$1,300.35
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $170.98 / $170.98 / $170.98	Professional	26	$170.98	$170.98	$170.98
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $408.92 / $899.10 / $899.10	Professional	TC	$408.92	$899.10	$899.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $110.48 / $314.41 / $561.22	Professional		$110.48	$314.41	$561.22
United Facility/Professional Professional Modifier Low / Median / High Price $380.57 / $799.20 / $1,511.55	Professional		$380.57	$799.20	$1,511.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.79 / $137.44 / $265.64	Professional	26	$81.79	$137.44	$265.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $282.80 / $607.98 / $1,190.98	Professional	TC	$282.80	$607.98	$1,190.98
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $796.48 / $999.76 / $999.76	Facility	26	$796.48	$999.76	$999.76
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,337.81 / $2,907.38 / $2,907.38	Professional		$2,337.81	$2,907.38	$2,907.38
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $687.65 / $881.25 / $881.25	Professional	26	$687.65	$881.25	$881.25
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,650.16 / $2,026.13 / $2,026.13	Professional	TC	$1,650.16	$2,026.13	$2,026.13