Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $45.71 / $288.40	Facility	26	$32.36	$45.71	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $190.55 / $478.63	Professional		$107.15	$190.55	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $54.95 / $144.54	Professional	26	$32.36	$54.95	$144.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $20.42 / $70.79 / $407.38	Professional	52	$20.42	$70.79	$407.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $107.15 / $263.03	Professional	TC	$79.43	$107.15	$263.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $100.00 / $213.80	Professional		$83.18	$100.00	$213.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $37.15 / $67.61	Professional	26	$26.92	$37.15	$67.61
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $23.99 / $29.51 / $309.03	Professional	52	$23.99	$29.51	$309.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $72.44 / $114.82	Professional	TC	$58.88	$72.44	$114.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $229.09	Professional		$199.53	$199.53	$229.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $107.15	Professional	26	$54.95	$85.11	$107.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $186.21 / $275.42	Professional	TC	$141.25	$186.21	$275.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $41.69 / $58.88	Facility	26	$8.91	$41.69	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $199.53 / $346.74	Professional		$117.49	$199.53	$346.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $54.95 / $95.50	Professional	26	$30.90	$54.95	$95.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $144.54 / $239.88	Professional	TC	$87.10	$144.54	$239.88
Medcost Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $323.59	Professional		$323.59	$323.59	$323.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $102.33 / $223.87	Professional		$36.31	$102.33	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $181.97 / $302.00	Professional		$125.89	$181.97	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $50.12 / $87.10	Professional	26	$35.48	$50.12	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $128.82 / $213.80	Professional	TC	$89.13	$128.82	$213.80
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $229.09 / $229.09 / $229.09	Facility	26	$229.09	$229.09	$229.09
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $831.76 / $1,071.52	Professional		$831.76	$831.76	$1,071.52
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $229.09 / $229.09 / $288.40	Professional	26	$229.09	$229.09	$288.40
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $602.56 / $602.56 / $776.25	Professional	TC	$602.56	$602.56	$776.25