Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.43 / $73.90 / $114.96	Facility	26	$68.43	$73.90	$114.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $381.47 / $415.02 / $1,117.69	Professional		$381.47	$415.02	$1,117.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.62 / $74.00 / $194.25	Professional	26	$67.62	$74.00	$194.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $311.22 / $358.42 / $855.79	Professional	TC	$311.22	$358.42	$855.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $305.17 / $495.91 / $900.52	Professional		$305.17	$495.91	$900.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.20 / $99.92 / $150.58	Professional	26	$56.20	$99.92	$150.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $117.10 / $161.30 / $207.76	Professional	26	$117.10	$161.30	$207.76
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $455.82 / $611.00 / $939.87	Professional	TC	$455.82	$611.00	$939.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.17 / $86.17 / $86.17	Facility	26	$86.17	$86.17	$86.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $474.29 / $774.21 / $1,253.19	Professional		$474.29	$774.21	$1,253.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.54 / $139.29 / $216.66	Professional	26	$84.54	$139.29	$216.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $385.64 / $680.81 / $1,053.81	Professional	TC	$385.64	$680.81	$1,053.81
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $113.33 / $113.33 / $219.10	Facility	26	$113.33	$113.33	$219.10
Medcost Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $510.00 / $609.00	Professional		$100.00	$510.00	$609.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $113.33 / $113.33 / $113.33	Professional	26	$113.33	$113.33	$113.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $115.52 / $524.70 / $939.70	Professional		$115.52	$524.70	$939.70
United Facility/Professional Professional Modifier Low / Median / High Price $454.42 / $741.73 / $1,228.48	Professional		$454.42	$741.73	$1,228.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.98 / $138.08 / $225.70	Professional	26	$77.98	$138.08	$225.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $375.07 / $610.71 / $1,031.44	Professional	TC	$375.07	$610.71	$1,031.44
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $178.45 / $201.25 / $367.41	Facility	26	$178.45	$201.25	$367.41
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,898.56 / $3,550.05 / $3,550.05	Professional		$2,898.56	$3,550.05	$3,550.05
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $479.37 / $597.08 / $597.08	Professional	26	$479.37	$597.08	$597.08
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,419.25 / $2,952.98 / $2,952.98	Professional	TC	$2,419.25	$2,952.98	$2,952.98