Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.52 / $66.14 / $101.01	Facility	26	$50.52	$66.14	$101.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.09 / $162.22 / $326.00	Professional		$152.09	$162.22	$326.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.52 / $54.60 / $156.22	Professional	26	$50.52	$54.60	$156.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.57 / $110.68 / $236.36	Professional	TC	$101.57	$110.68	$236.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $172.79 / $172.79 / $172.79	Professional		$172.79	$172.79	$172.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.37 / $74.76 / $103.55	Professional	26	$56.37	$74.76	$103.55
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.52 / $131.05 / $155.97	Professional	26	$83.52	$131.05	$155.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.02 / $274.08 / $352.38	Professional	TC	$194.02	$274.08	$352.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.82 / $63.82 / $63.82	Facility	26	$63.82	$63.82	$63.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $215.33 / $319.89 / $481.42	Professional		$215.33	$319.89	$481.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.94 / $103.88 / $162.35	Professional	26	$61.94	$103.88	$162.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.91 / $213.66 / $321.80	Professional	TC	$151.91	$213.66	$321.80
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $86.91 / $101.00 / $161.19	Facility	26	$86.91	$101.00	$161.19
Medcost Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $152.00 / $227.00	Professional		$75.00	$152.00	$227.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $86.91 / $86.91 / $86.91	Professional	26	$86.91	$86.91	$86.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $289.80 / $370.90 / $467.60	Professional		$289.80	$370.90	$467.60
United Facility/Professional Professional Modifier Low / Median / High Price $169.48 / $251.09 / $470.17	Professional		$169.48	$251.09	$470.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.78 / $76.70 / $161.69	Professional	26	$57.78	$76.70	$161.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $108.73 / $174.90 / $315.45	Professional	TC	$108.73	$174.90	$315.45
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $132.57 / $171.79 / $272.41	Facility	26	$132.57	$171.79	$272.41
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,809.00 / $1,809.00 / $1,809.00	Professional		$1,809.00	$1,809.00	$1,809.00
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $543.00 / $543.00 / $543.00	Professional	26	$543.00	$543.00	$543.00
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,266.00 / $1,266.00 / $1,266.00	Professional	TC	$1,266.00	$1,266.00	$1,266.00