Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.84 / $103.56 / $164.61	Facility	26	$94.84	$103.56	$164.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $381.20 / $401.75 / $1,207.79	Professional		$381.20	$401.75	$1,207.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.71 / $103.56 / $180.80	Professional	26	$90.71	$103.56	$180.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $298.18 / $298.19 / $515.44	Professional	TC	$298.18	$298.19	$515.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.22 / $132.75 / $177.38	Professional	26	$79.22	$132.75	$177.38
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $99.15 / $159.24 / $263.14	Professional	26	$99.15	$159.24	$263.14
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $266.63 / $453.27 / $1,113.88	Professional	TC	$266.63	$453.27	$1,113.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.59 / $119.59 / $119.59	Facility	26	$119.59	$119.59	$119.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $447.76 / $686.99 / $1,188.76	Professional		$447.76	$686.99	$1,188.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.44 / $171.52 / $283.52	Professional	26	$111.44	$171.52	$283.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $336.32 / $509.91 / $894.91	Professional	TC	$336.32	$509.91	$894.91
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $151.34 / $151.34 / $254.82	Facility	26	$151.34	$151.34	$254.82
Medcost Facility/Professional Professional Modifier Low / Median / High Price $131.00 / $454.00 / $585.00	Professional		$131.00	$454.00	$585.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $151.34 / $151.34 / $151.34	Professional	26	$151.34	$151.34	$151.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $148.60 / $437.34 / $613.40	Professional		$148.60	$437.34	$613.40
United Facility/Professional Professional Modifier Low / Median / High Price $432.91 / $597.12 / $1,133.78	Professional		$432.91	$597.12	$1,133.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.44 / $152.72 / $284.12	Professional	26	$102.44	$152.72	$284.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $326.72 / $449.14 / $884.13	Professional	TC	$326.72	$449.14	$884.13
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $246.31 / $246.31 / $529.44	Facility	26	$246.31	$246.31	$529.44
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,670.75 / $2,670.75 / $3,379.95	Professional		$2,670.75	$2,670.75	$3,379.95
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $657.16 / $657.16 / $856.05	Professional	26	$657.16	$657.16	$856.05
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,013.59 / $2,013.59 / $2,523.98	Professional	TC	$2,013.59	$2,013.59	$2,523.98