Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.75 / $94.65 / $127.69	Facility		$66.75	$94.65	$127.69
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.22 / $32.59 / $42.85	Facility	26	$27.22	$32.59	$42.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.90 / $121.56 / $365.64	Professional		$82.90	$121.56	$365.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.49 / $58.95 / $352.38	Professional	26	$32.49	$58.95	$352.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.82 / $73.48 / $168.44	Professional	TC	$59.82	$73.48	$168.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $116.32 / $116.32 / $116.32	Professional		$116.32	$116.32	$116.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.95 / $42.29 / $54.88	Professional	26	$18.95	$42.29	$54.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $74.38 / $74.38 / $74.38	Professional	TC	$74.38	$74.38	$74.38
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.10 / $84.96 / $111.91	Professional	26	$34.10	$84.96	$111.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.26 / $70.11 / $113.44	Professional	TC	$63.26	$70.11	$113.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.38 / $92.58 / $204.25	Professional		$52.38	$92.58	$204.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.30 / $31.23 / $92.56	Professional	26	$20.30	$31.23	$92.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.57 / $41.68 / $122.04	Professional	TC	$25.57	$41.68	$122.04
Medcost Facility/Professional Facility Modifier Low / Median / High Price $109.03 / $166.32 / $212.75	Facility		$109.03	$166.32	$212.75
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $64.00 / $75.93 / $121.49	Facility	26	$64.00	$75.93	$121.49
Medcost Facility/Professional Professional Modifier Low / Median / High Price $104.26 / $104.26 / $104.26	Professional		$104.26	$104.26	$104.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.84 / $70.72 / $242.51	Professional		$24.84	$70.72	$242.51
United Facility/Professional Professional Modifier Low / Median / High Price $68.47 / $112.55 / $198.71	Professional		$68.47	$112.55	$198.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.82 / $43.03 / $84.96	Professional	26	$25.82	$43.03	$84.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.27 / $69.72 / $125.05	Professional	TC	$38.27	$69.72	$125.05
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $633.51 / $633.51 / $633.51	Facility		$633.51	$633.51	$633.51
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $221.64 / $221.64 / $221.64	Facility	26	$221.64	$221.64	$221.64
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $764.45 / $764.45 / $991.43	Professional		$764.45	$764.45	$991.43
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $311.07 / $311.07 / $319.80	Professional	26	$311.07	$311.07	$319.80
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $507.20 / $507.20 / $671.63	Professional	TC	$507.20	$507.20	$671.63