Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $75.86 / $141.25	Facility	26	$50.12	$75.86	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $181.97 / $446.68	Professional		$141.25	$181.97	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $75.86 / $173.78	Professional	26	$46.77	$75.86	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $117.49 / $288.40	Professional	TC	$93.33	$117.49	$288.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $70.79 / $104.71	Professional	26	$48.98	$70.79	$104.71
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $134.90 / $162.18	Professional	26	$79.43	$134.90	$162.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $275.42 / $380.19	Professional	TC	$186.21	$275.42	$380.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $63.10 / $91.20	Facility	26	$13.49	$63.10	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $316.23 / $489.78	Professional		$223.87	$316.23	$489.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $102.33 / $162.18	Professional	26	$63.10	$102.33	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $218.78 / $323.59	Professional	TC	$151.36	$218.78	$323.59
Medcost Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Professional		$371.54	$371.54	$371.54
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Professional	26	$107.15	$107.15	$107.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $407.38 / $467.74	Professional		$288.40	$407.38	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $257.04 / $467.74	Professional		$165.96	$257.04	$467.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $75.86 / $154.88	Professional	26	$57.54	$75.86	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $181.97 / $309.03	Professional	TC	$109.65	$181.97	$309.03
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $354.81 / $354.81 / $354.81	Facility	26	$354.81	$354.81	$354.81
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Professional		$1,819.70	$1,819.70	$1,819.70
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $537.03 / $537.03 / $537.03	Professional	26	$537.03	$537.03	$537.03
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Professional	TC	$1,258.93	$1,258.93	$1,258.93