Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $9.92 / $93.23 / $147.37	Facility		$9.92	$93.23	$147.37
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.35 / $53.60 / $54.75	Facility	26	$45.35	$53.60	$54.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.90 / $134.83 / $315.20	Professional		$112.90	$134.83	$315.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.79 / $66.33 / $201.24	Professional	26	$54.79	$66.33	$201.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.69 / $71.73 / $179.77	Professional	TC	$56.69	$71.73	$179.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $155.56 / $167.94 / $308.47	Professional		$155.56	$167.94	$308.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.83 / $71.20 / $145.65	Professional	26	$31.83	$71.20	$145.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $97.58 / $97.58 / $97.58	Professional	TC	$97.58	$97.58	$97.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.29 / $101.86 / $131.12	Professional	26	$57.29	$101.86	$131.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.25 / $74.50 / $141.54	Professional	TC	$42.25	$74.50	$141.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.61 / $103.56 / $240.86	Professional		$62.61	$103.56	$240.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.85 / $54.80 / $122.10	Professional	26	$32.85	$54.80	$122.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.89 / $46.11 / $128.13	Professional	TC	$28.89	$46.11	$128.13
Medcost Facility/Professional Facility Modifier Low / Median / High Price $106.00 / $148.00 / $269.00	Facility		$106.00	$148.00	$269.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $65.13 / $94.00 / $130.59	Facility	26	$65.13	$94.00	$130.59
Medcost Facility/Professional Professional Modifier Low / Median / High Price $63.00 / $63.00 / $63.00	Professional		$63.00	$63.00	$63.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.70 / $101.91 / $234.81	Professional		$42.70	$101.91	$234.81
United Facility/Professional Professional Modifier Low / Median / High Price $77.97 / $139.63 / $246.91	Professional		$77.97	$139.63	$246.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.34 / $67.08 / $118.37	Professional	26	$40.34	$67.08	$118.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.51 / $69.48 / $125.06	Professional	TC	$39.51	$69.48	$125.06
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $905.83 / $905.83 / $905.83	Facility		$905.83	$905.83	$905.83
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $336.59 / $336.59 / $336.59	Facility	26	$336.59	$336.59	$336.59
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,961.76 / $1,961.76 / $1,961.76	Professional		$1,961.76	$1,961.76	$1,961.76
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $434.05 / $434.05 / $539.70	Professional	26	$434.05	$434.05	$539.70
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $557.54 / $557.54 / $887.33	Professional	TC	$557.54	$557.54	$887.33