Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.63 / $36.40 / $60.05	Facility	26	$34.63	$36.40	$60.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.12 / $132.38 / $537.73	Professional		$106.12	$132.38	$537.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.86 / $36.00 / $93.90	Professional	26	$32.86	$36.00	$93.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.69 / $87.07 / $213.30	Professional	TC	$75.69	$87.07	$213.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.48 / $123.50 / $257.29	Professional		$91.48	$123.50	$257.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.60 / $58.99 / $80.44	Professional	26	$28.60	$58.99	$80.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $62.89 / $64.31 / $119.48	Professional	TC	$62.89	$64.31	$119.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $200.00 / $209.90	Professional		$200.00	$200.00	$209.90
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.56 / $88.44 / $111.03	Professional	26	$62.56	$88.44	$111.03
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $141.55 / $176.94 / $256.86	Professional	TC	$141.55	$176.94	$256.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.97 / $43.97 / $43.97	Facility	26	$43.97	$43.97	$43.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.28 / $203.20 / $343.20	Professional		$131.28	$203.20	$343.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.20 / $60.94 / $106.53	Professional	26	$40.20	$60.94	$106.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.55 / $141.29 / $239.14	Professional	TC	$90.55	$141.29	$239.14
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $44.69 / $58.11 / $116.22	Facility	26	$44.69	$58.11	$116.22
Medcost Facility/Professional Professional Modifier Low / Median / High Price $49.00 / $162.00 / $451.09	Professional		$49.00	$162.00	$451.09
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $58.11 / $58.11 / $58.11	Professional	26	$58.11	$58.11	$58.11
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $132.69 / $309.49 / $309.49	Professional	TC	$132.69	$309.49	$309.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.14 / $116.73 / $206.67	Professional		$40.14	$116.73	$206.67
United Facility/Professional Professional Modifier Low / Median / High Price $126.88 / $193.99 / $333.25	Professional		$126.88	$193.99	$333.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.65 / $61.25 / $105.84	Professional	26	$38.65	$61.25	$105.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.87 / $136.93 / $231.65	Professional	TC	$87.87	$136.93	$231.65
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $90.38 / $187.10 / $187.10	Facility	26	$90.38	$187.10	$187.10
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $810.58 / $1,053.68 / $1,053.68	Professional		$810.58	$1,053.68	$1,053.68
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $242.65 / $307.35 / $307.35	Professional	26	$242.65	$307.35	$307.35
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $567.92 / $746.33 / $746.33	Professional	TC	$567.92	$746.33	$746.33