Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $137.65 / $149.40 / $237.86	Facility	26	$137.65	$149.40	$237.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.18 / $273.85 / $750.21	Professional		$255.18	$273.85	$750.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.81 / $149.40 / $382.02	Professional	26	$131.81	$149.40	$382.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.37 / $124.45 / $238.86	Professional	TC	$123.37	$124.45	$238.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $372.88 / $372.88 / $372.88	Professional		$372.88	$372.88	$372.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $115.38 / $151.41 / $257.55	Professional	26	$115.38	$151.41	$257.55
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $215.73 / $290.50 / $411.33	Professional	26	$215.73	$290.50	$411.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $187.20 / $280.80 / $356.93	Professional	TC	$187.20	$280.80	$356.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $173.11 / $173.11 / $173.11	Facility	26	$173.11	$173.11	$173.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $299.43 / $440.16 / $770.25	Professional		$299.43	$440.16	$770.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $161.83 / $236.26 / $408.82	Professional	26	$161.83	$236.26	$408.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $137.60 / $203.90 / $355.35	Professional	TC	$137.60	$203.90	$355.35
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $176.98 / $219.66 / $424.68	Facility	26	$176.98	$219.66	$424.68
Medcost Facility/Professional Professional Modifier Low / Median / High Price $174.00 / $190.00 / $363.00	Professional		$174.00	$190.00	$363.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $219.66 / $219.66 / $219.66	Professional	26	$219.66	$219.66	$219.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $185.50 / $226.94 / $440.52	Professional		$185.50	$226.94	$440.52
United Facility/Professional Professional Modifier Low / Median / High Price $277.77 / $380.75 / $761.02	Professional		$277.77	$380.75	$761.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $148.12 / $196.48 / $412.40	Professional	26	$148.12	$196.48	$412.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.57 / $182.82 / $353.30	Professional	TC	$128.57	$182.82	$353.30
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $357.82 / $357.82 / $769.74	Facility	26	$357.82	$357.82	$769.74
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,788.06 / $1,788.06 / $2,427.08	Professional		$1,788.06	$1,788.06	$2,427.08
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $948.42 / $948.42 / $1,251.23	Professional	26	$948.42	$948.42	$1,251.23
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $839.64 / $839.64 / $1,175.84	Professional	TC	$839.64	$839.64	$1,175.84