Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.23 / $121.86 / $170.65	Facility	26	$105.23	$121.86	$170.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.50 / $179.81 / $372.27	Professional		$132.50	$179.81	$372.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.92 / $105.24 / $290.19	Professional	26	$90.92	$105.24	$290.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.26 / $27.26 / $163.22	Professional	TC	$27.26	$27.26	$163.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $189.48 / $189.48 / $189.48	Professional		$189.48	$189.48	$189.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.75 / $134.56 / $302.79	Professional	26	$80.75	$134.56	$302.79
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $150.94 / $210.05 / $276.36	Professional	26	$150.94	$210.05	$276.36
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.45 / $171.24 / $625.74	Professional	TC	$81.45	$171.24	$625.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $121.50 / $121.50 / $121.50	Facility	26	$121.50	$121.50	$121.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.98 / $361.67 / $739.78	Professional		$190.98	$361.67	$739.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.90 / $164.64 / $286.79	Professional	26	$105.90	$164.64	$286.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.79 / $113.36 / $542.04	Professional	TC	$39.79	$113.36	$542.04
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $151.26 / $202.00 / $368.80	Facility	26	$151.26	$202.00	$368.80
Medcost Facility/Professional Professional Modifier Low / Median / High Price $49.00 / $133.00 / $182.00	Professional		$49.00	$133.00	$182.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $151.26 / $151.26 / $151.26	Professional	26	$151.26	$151.26	$151.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $48.87 / $165.97 / $346.00	Professional		$48.87	$165.97	$346.00
United Facility/Professional Professional Modifier Low / Median / High Price $131.71 / $267.05 / $454.32	Professional		$131.71	$267.05	$454.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.51 / $152.72 / $289.19	Professional	26	$102.51	$152.72	$289.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.80 / $66.29 / $332.88	Professional	TC	$27.80	$66.29	$332.88
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $250.54 / $250.54 / $722.52	Facility	26	$250.54	$250.54	$722.52
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,104.86 / $3,104.86 / $3,104.86	Professional		$3,104.86	$3,104.86	$3,104.86
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $873.45 / $1,056.82 / $1,056.82	Professional	26	$873.45	$1,056.82	$1,056.82
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,563.11 / $2,563.11 / $2,563.11	Professional	TC	$2,563.11	$2,563.11	$2,563.11