Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $411.57 / $442.74 / $654.85	Facility	26	$411.57	$442.74	$654.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,747.32 / $1,889.42 / $5,133.00	Professional		$1,747.32	$1,889.42	$5,133.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $353.64 / $411.58 / $1,133.85	Professional	26	$353.64	$411.58	$1,133.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,267.58 / $1,335.76 / $2,474.75	Professional	TC	$1,267.58	$1,335.76	$2,474.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,329.38 / $1,417.67 / $2,326.41	Professional		$1,329.38	$1,417.67	$2,326.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $317.56 / $555.51 / $732.30	Professional	26	$317.56	$555.51	$732.30
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $553.22 / $808.32 / $1,054.80	Professional	26	$553.22	$808.32	$1,054.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,789.21 / $3,280.22 / $4,226.45	Professional	TC	$1,789.21	$3,280.22	$4,226.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $477.29 / $477.29 / $477.29	Facility	26	$477.29	$477.29	$477.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,697.51 / $2,879.41 / $5,114.87	Professional		$1,697.51	$2,879.41	$5,114.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $405.69 / $627.64 / $1,125.53	Professional	26	$405.69	$627.64	$1,125.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,308.73 / $2,302.59 / $3,956.37	Professional	TC	$1,308.73	$2,302.59	$3,956.37
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $577.35 / $674.00 / $1,121.00	Facility	26	$577.35	$674.00	$1,121.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $522.00 / $1,930.00 / $2,452.00	Professional		$522.00	$1,930.00	$2,452.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $2,442.27 / $2,442.27 / $2,442.27	Professional	TC	$2,442.27	$2,442.27	$2,442.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $592.75 / $2,052.96 / $3,710.30	Professional		$592.75	$2,052.96	$3,710.30
United Facility/Professional Professional Modifier Low / Median / High Price $1,824.76 / $2,564.48 / $5,028.14	Professional		$1,824.76	$2,564.48	$5,028.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $391.16 / $589.96 / $1,136.90	Professional	26	$391.16	$589.96	$1,136.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,346.59 / $1,974.53 / $3,844.42	Professional	TC	$1,346.59	$1,974.53	$3,844.42
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $985.21 / $985.21 / $2,118.79	Facility	26	$985.21	$985.21	$2,118.79
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $13,988.24 / $13,988.24 / $15,609.38	Professional		$13,988.24	$13,988.24	$15,609.38
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $2,958.87 / $2,958.87 / $3,439.95	Professional	26	$2,958.87	$2,958.87	$3,439.95
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $9,015.64 / $9,015.64 / $12,169.43	Professional	TC	$9,015.64	$9,015.64	$12,169.43