Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.98 / $60.98 / $162.16	Facility	26	$60.98	$60.98	$162.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $399.26 / $422.79 / $725.20	Professional		$399.26	$422.79	$725.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.75 / $64.18 / $185.87	Professional	26	$58.75	$64.18	$185.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $338.29 / $364.04 / $622.12	Professional	TC	$338.29	$364.04	$622.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $98.80 / $109.81 / $141.19	Professional	26	$98.80	$109.81	$141.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $114.03 / $164.06 / $203.83	Professional	26	$114.03	$164.06	$203.83
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $645.52 / $917.33 / $1,153.86	Professional	TC	$645.52	$917.33	$1,153.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.76 / $76.76 / $76.76	Facility	26	$76.76	$76.76	$76.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $545.90 / $877.79 / $1,318.01	Professional		$545.90	$877.79	$1,318.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.77 / $126.40 / $198.41	Professional	26	$78.77	$126.40	$198.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $463.29 / $738.64 / $1,118.59	Professional	TC	$463.29	$738.64	$1,118.59
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $93.42 / $107.79 / $181.17	Facility	26	$93.42	$107.79	$181.17
Medcost Facility/Professional Professional Modifier Low / Median / High Price $712.97 / $712.97 / $712.97	Professional		$712.97	$712.97	$712.97
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $107.79 / $107.79 / $107.79	Professional	26	$107.79	$107.79	$107.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,260.70 / $1,260.70 / $1,260.70	Professional		$1,260.70	$1,260.70	$1,260.70
United Facility/Professional Professional Modifier Low / Median / High Price $471.25 / $617.39 / $1,286.23	Professional		$471.25	$617.39	$1,286.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.20 / $93.76 / $197.62	Professional	26	$70.20	$93.76	$197.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $403.45 / $547.12 / $1,090.13	Professional	TC	$403.45	$547.12	$1,090.13
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $160.18 / $160.18 / $326.42	Facility	26	$160.18	$160.18	$326.42
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,964.79 / $3,582.00 / $3,582.00	Professional		$2,964.79	$3,582.00	$3,582.00
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $426.62 / $532.35 / $532.35	Professional	26	$426.62	$532.35	$532.35
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,538.10 / $3,049.65 / $3,049.65	Professional	TC	$2,538.10	$3,049.65	$3,049.65