Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.25 / $28.24 / $33.03	Facility	26	$23.25	$28.24	$33.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.20 / $100.92 / $250.00	Professional		$75.20	$100.92	$250.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.16 / $37.72 / $78.59	Professional	26	$28.16	$37.72	$78.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.27 / $72.69 / $190.10	Professional	TC	$54.27	$72.69	$190.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.87 / $89.87 / $105.31	Professional		$89.87	$89.87	$105.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.17 / $46.86 / $91.65	Professional	26	$32.17	$46.86	$91.65
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.56 / $68.84 / $83.76	Professional	26	$29.56	$68.84	$83.76
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.74 / $75.93 / $140.49	Professional	TC	$47.74	$75.93	$140.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.42 / $73.14 / $215.30	Professional		$44.42	$73.14	$215.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.60 / $30.19 / $72.95	Professional	26	$17.60	$30.19	$72.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.65 / $53.24 / $153.40	Professional	TC	$23.65	$53.24	$153.40
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $58.12 / $71.00 / $82.00	Facility	26	$58.12	$71.00	$82.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $80.09 / $80.09 / $80.09	Professional		$80.09	$80.09	$80.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $21.35 / $83.91 / $165.92	Professional		$21.35	$83.91	$165.92
United Facility/Professional Professional Modifier Low / Median / High Price $58.08 / $109.11 / $183.92	Professional		$58.08	$109.11	$183.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.03 / $35.75 / $67.02	Professional	26	$22.03	$35.75	$67.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.69 / $58.84 / $118.23	Professional	TC	$31.69	$58.84	$118.23
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $173.52 / $173.52 / $173.52	Facility	26	$173.52	$173.52	$173.52
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $973.09 / $973.09 / $1,210.28	Professional		$973.09	$973.09	$1,210.28
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $237.42 / $237.42 / $277.27	Professional	26	$237.42	$237.42	$277.27
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $750.23 / $750.23 / $933.00	Professional	TC	$750.23	$750.23	$933.00