Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.29 / $103.35 / $286.00	Facility		$49.29	$103.35	$286.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.77 / $28.16 / $30.37	Facility	26	$24.77	$28.16	$30.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.56 / $207.44 / $622.32	Professional		$112.56	$207.44	$622.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.77 / $39.31 / $250.14	Professional	26	$29.77	$39.31	$250.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.95 / $100.17 / $378.12	Professional	TC	$68.95	$100.17	$378.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $166.62 / $166.62 / $166.62	Professional		$166.62	$166.62	$166.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.72 / $38.72 / $79.45	Professional	26	$38.72	$38.72	$79.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $127.89 / $127.89 / $127.89	Professional	TC	$127.89	$127.89	$127.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.78 / $60.71 / $75.97	Professional	26	$31.78	$60.71	$75.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $98.00 / $109.77 / $172.39	Professional	TC	$98.00	$109.77	$172.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.28 / $83.66 / $261.73	Professional		$57.28	$83.66	$261.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.60 / $21.48 / $68.29	Professional	26	$18.60	$21.48	$68.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.72 / $64.04 / $196.23	Professional	TC	$36.72	$64.04	$196.23
Medcost Facility/Professional Facility Modifier Low / Median / High Price $129.93 / $165.81 / $204.50	Facility		$129.93	$165.81	$204.50
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $58.66 / $58.66 / $58.66	Facility	26	$58.66	$58.66	$58.66
Medcost Facility/Professional Professional Modifier Low / Median / High Price $137.69 / $137.69 / $137.69	Professional		$137.69	$137.69	$137.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.54 / $109.47 / $382.43	Professional		$23.54	$109.47	$382.43
United Facility/Professional Professional Modifier Low / Median / High Price $70.15 / $114.84 / $245.56	Professional		$70.15	$114.84	$245.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.30 / $36.71 / $66.43	Professional	26	$22.30	$36.71	$66.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.73 / $81.51 / $189.48	Professional	TC	$45.73	$81.51	$189.48
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $928.91 / $928.91 / $928.91	Facility		$928.91	$928.91	$928.91
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $213.67 / $213.67 / $213.67	Facility	26	$213.67	$213.67	$213.67
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,081.50 / $1,081.50 / $1,445.93	Professional		$1,081.50	$1,081.50	$1,445.93
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $235.79 / $235.79 / $299.10	Professional	26	$235.79	$235.79	$299.10
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $845.71 / $845.71 / $1,146.83	Professional	TC	$845.71	$845.71	$1,146.83