Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.01 / $85.88 / $128.34	Facility	26	$81.01	$85.88	$128.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $428.63 / $481.64 / $1,294.35	Professional		$428.63	$481.64	$1,294.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.50 / $81.02 / $198.39	Professional	26	$69.50	$81.02	$198.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $351.26 / $358.00 / $621.46	Professional	TC	$351.26	$358.00	$621.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $337.39 / $337.39 / $552.34	Professional		$337.39	$337.39	$552.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.01 / $103.45 / $232.53	Professional	26	$62.01	$103.45	$232.53
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.59 / $156.63 / $205.00	Professional	26	$112.59	$156.63	$205.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $420.14 / $848.31 / $1,126.95	Professional	TC	$420.14	$848.31	$1,126.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.59 / $93.59 / $93.59	Facility	26	$93.59	$93.59	$93.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $383.11 / $688.81 / $1,307.13	Professional		$383.11	$688.81	$1,307.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.84 / $122.64 / $219.78	Professional	26	$78.84	$122.64	$219.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $306.69 / $578.57 / $1,079.83	Professional	TC	$306.69	$578.57	$1,079.83
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $112.67 / $151.00 / $255.10	Facility	26	$112.67	$151.00	$255.10
Medcost Facility/Professional Professional Modifier Low / Median / High Price $102.00 / $545.00 / $648.00	Professional		$102.00	$545.00	$648.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $112.67 / $112.67 / $112.67	Professional	26	$112.67	$112.67	$112.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $116.20 / $526.62 / $995.80	Professional		$116.20	$526.62	$995.80
United Facility/Professional Professional Modifier Low / Median / High Price $411.97 / $648.19 / $1,247.74	Professional		$411.97	$648.19	$1,247.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.43 / $118.29 / $222.89	Professional	26	$76.43	$118.29	$222.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $344.88 / $551.23 / $1,040.88	Professional	TC	$344.88	$551.23	$1,040.88
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $192.44 / $215.97 / $1,357.70	Facility	26	$192.44	$215.97	$1,357.70
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $4,499.00 / $4,499.00 / $4,499.00	Professional		$4,499.00	$4,499.00	$4,499.00
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $1,350.00 / $1,350.00 / $1,350.00	Professional	26	$1,350.00	$1,350.00	$1,350.00
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $3,149.00 / $3,149.00 / $3,149.00	Professional	TC	$3,149.00	$3,149.00	$3,149.00