Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.00 / $64.89 / $117.12	Professional		$54.00	$64.89	$117.12
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $66.36 / $66.36 / $81.93	Professional	25	$66.36	$66.36	$81.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.66 / $26.26 / $62.27	Professional	26	$22.66	$26.26	$62.27
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $117.97 / $389.65 / $389.65	Professional	50	$117.97	$389.65	$389.65
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.38 / $30.13 / $43.93	Professional	52	$26.38	$30.13	$43.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.78 / $35.47 / $62.82	Professional	TC	$30.78	$35.47	$62.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.16 / $58.96 / $107.85	Professional		$57.16	$58.96	$107.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.72 / $104.72 / $104.72	Professional		$104.72	$104.72	$104.72
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $29.74 / $59.38	Professional	26	$24.78	$29.74	$59.38
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.41 / $33.50 / $105.21	Professional	TC	$29.41	$33.50	$105.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.84 / $70.84 / $70.84	Facility		$70.84	$70.84	$70.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.14 / $30.14 / $30.14	Facility	26	$30.14	$30.14	$30.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.04 / $88.28 / $157.60	Professional		$47.04	$88.28	$157.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.79 / $37.61 / $68.19	Professional	26	$18.79	$37.61	$68.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.01 / $50.92 / $89.53	Professional	TC	$27.01	$50.92	$89.53
Medcost Facility/Professional Facility Modifier Low / Median / High Price $51.88 / $73.00 / $109.12	Facility		$51.88	$73.00	$109.12
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $26.00 / $26.00 / $41.04	Facility	26	$26.00	$26.00	$41.04
Medcost Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $45.00 / $79.00	Professional		$35.00	$45.00	$79.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.36 / $51.36 / $99.00	Professional		$38.36	$51.36	$99.00
United Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $55.89 / $114.50	Professional		$38.54	$55.89	$114.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.68 / $23.93 / $42.44	Professional	26	$14.68	$23.93	$42.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.46 / $30.82 / $57.35	Professional	TC	$23.46	$30.82	$57.35
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $120.69 / $129.86 / $333.50	Facility		$120.69	$129.86	$333.50
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $61.29 / $100.00 / $152.15	Facility	26	$61.29	$100.00	$152.15
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $403.38 / $403.38 / $524.78	Professional		$403.38	$403.38	$524.78
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $167.21 / $167.21 / $212.40	Professional	26	$167.21	$167.21	$212.40
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $264.83 / $264.83 / $312.38	Professional	TC	$264.83	$264.83	$312.38