Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.90 / $142.03 / $224.13	Facility	26	$100.90	$142.03	$224.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.74 / $330.97 / $590.40	Professional		$293.74	$330.97	$590.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.57 / $100.90 / $263.82	Professional	26	$89.57	$100.90	$263.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.15 / $230.07 / $426.90	Professional	TC	$204.15	$230.07	$426.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.54 / $128.87 / $170.60	Professional	26	$77.54	$128.87	$170.60
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $148.57 / $200.70 / $283.27	Professional	26	$148.57	$200.70	$283.27
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $248.02 / $384.42 / $591.10	Professional	TC	$248.02	$384.42	$591.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.54 / $116.54 / $116.54	Facility	26	$116.54	$116.54	$116.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $337.06 / $497.05 / $869.81	Professional		$337.06	$497.05	$869.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.80 / $160.13 / $275.27	Professional	26	$108.80	$160.13	$275.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $227.37 / $342.81 / $592.72	Professional	TC	$227.37	$342.81	$592.72
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $162.90 / $229.59 / $304.14	Facility	26	$162.90	$229.59	$304.14
Medcost Facility/Professional Professional Modifier Low / Median / High Price $127.00 / $276.00 / $403.00	Professional		$127.00	$276.00	$403.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $309.83 / $309.83 / $309.83	Professional	TC	$309.83	$309.83	$309.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $144.78 / $335.79 / $522.69	Professional		$144.78	$335.79	$522.69
United Facility/Professional Professional Modifier Low / Median / High Price $311.99 / $416.68 / $883.03	Professional		$311.99	$416.68	$883.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.32 / $144.53 / $279.00	Professional	26	$99.32	$144.53	$279.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $209.01 / $283.75 / $601.16	Professional	TC	$209.01	$283.75	$601.16
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $240.70 / $240.70 / $517.75	Facility	26	$240.70	$240.70	$517.75
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,193.48 / $2,193.48 / $2,933.78	Professional		$2,193.48	$2,193.48	$2,933.78
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $640.52 / $640.52 / $837.45	Professional	26	$640.52	$640.52	$837.45
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,552.95 / $1,552.95 / $2,096.33	Professional	TC	$1,552.95	$1,552.95	$2,096.33