Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.82 / $23.93 / $42.96	Facility	26	$23.82	$23.93	$42.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.43 / $92.43 / $230.87	Professional		$84.43	$92.43	$230.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.87 / $23.93 / $68.97	Professional	26	$22.87	$23.93	$68.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.97 / $67.59 / $137.19	Professional	TC	$59.97	$67.59	$137.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.78 / $73.78 / $73.78	Professional		$73.78	$73.78	$73.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.85 / $47.11 / $67.03	Professional	26	$19.85	$47.11	$67.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.35 / $63.35 / $63.35	Professional		$63.35	$63.35	$63.35
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.54 / $58.64 / $75.88	Professional	26	$40.54	$58.64	$75.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $94.25 / $134.79 / $175.27	Professional	TC	$94.25	$134.79	$175.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.07 / $30.07 / $30.07	Facility	26	$30.07	$30.07	$30.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.98 / $148.25 / $250.13	Professional		$86.98	$148.25	$250.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.11 / $41.80 / $73.27	Professional	26	$25.11	$41.80	$73.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.88 / $102.85 / $180.26	Professional	TC	$61.88	$102.85	$180.26
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $30.86 / $43.80 / $81.77	Facility	26	$30.86	$43.80	$81.77
Medcost Facility/Professional Professional Modifier Low / Median / High Price $34.00 / $75.00 / $128.00	Professional		$34.00	$75.00	$128.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $97.85 / $97.85 / $97.85	Professional	26	$97.85	$97.85	$97.85
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $96.48 / $96.48 / $97.10	Professional	TC	$96.48	$96.48	$97.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $46.22 / $125.30 / $182.60	Professional		$46.22	$125.30	$182.60
United Facility/Professional Professional Modifier Low / Median / High Price $87.40 / $117.38 / $223.94	Professional		$87.40	$117.38	$223.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.09 / $38.86 / $70.43	Professional	26	$26.09	$38.86	$70.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.54 / $85.31 / $165.53	Professional	TC	$60.54	$85.31	$165.53
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $80.00 / $127.92 / $127.92	Facility	26	$80.00	$127.92	$127.92
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $642.13 / $832.58 / $832.58	Professional		$642.13	$832.58	$832.58
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $167.46 / $210.75 / $210.75	Professional	26	$167.46	$210.75	$210.75
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $474.67 / $621.90 / $621.90	Professional	TC	$474.67	$621.90	$621.90