Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.36 / $54.93 / $76.54	Facility	26	$41.36	$54.93	$76.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.22 / $189.22 / $280.83	Professional		$189.22	$189.22	$280.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.96 / $41.37 / $104.53	Professional	26	$40.96	$41.37	$104.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.85 / $147.85 / $231.40	Professional	TC	$147.85	$147.85	$231.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $433.62 / $433.62 / $433.62	Professional		$433.62	$433.62	$433.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $95.49 / $95.49 / $95.49	Professional	26	$95.49	$95.49	$95.49
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.76 / $107.30 / $128.47	Professional	26	$71.76	$107.30	$128.47
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $260.33 / $360.37 / $535.41	Professional	TC	$260.33	$360.37	$535.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.16 / $52.16 / $52.16	Facility	26	$52.16	$52.16	$52.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.83 / $405.09 / $637.73	Professional		$263.83	$405.09	$637.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.22 / $86.12 / $134.57	Professional	26	$50.22	$86.12	$134.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.04 / $320.01 / $510.43	Professional	TC	$210.04	$320.01	$510.43
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $72.12 / $82.00 / $174.87	Facility	26	$72.12	$82.00	$174.87
Medcost Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $234.00 / $295.00	Professional		$61.00	$234.00	$295.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $72.12 / $72.12 / $72.12	Professional	26	$72.12	$72.12	$72.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $69.79 / $253.96 / $444.50	Professional		$69.79	$253.96	$444.50
United Facility/Professional Professional Modifier Low / Median / High Price $220.47 / $317.20 / $606.29	Professional		$220.47	$317.20	$606.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.14 / $62.46 / $130.30	Professional	26	$47.14	$62.46	$130.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $172.84 / $257.85 / $473.88	Professional	TC	$172.84	$257.85	$473.88
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $107.73 / $134.97 / $221.68	Facility	26	$107.73	$134.97	$221.68
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,525.44 / $1,525.44 / $1,736.48	Professional		$1,525.44	$1,525.44	$1,736.48
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $501.94 / $501.94 / $501.94	Professional	26	$501.94	$501.94	$501.94
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,268.71 / $1,268.71 / $1,373.85	Professional	TC	$1,268.71	$1,268.71	$1,373.85