Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.01 / $41.01 / $44.75	Facility	26	$41.01	$41.01	$44.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.48 / $142.36 / $283.80	Professional		$99.48	$142.36	$283.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.99 / $43.44 / $98.30	Professional	26	$39.99	$43.44	$98.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.69 / $90.37 / $209.38	Professional	TC	$69.69	$90.37	$209.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.52 / $112.52 / $112.52	Professional		$112.52	$112.52	$112.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.67 / $54.67 / $54.67	Professional	26	$54.67	$54.67	$54.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.92 / $108.92 / $108.92	Professional		$108.92	$108.92	$108.92
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.15 / $74.16 / $109.32	Professional	26	$39.15	$74.16	$109.32
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $76.22 / $112.26 / $189.59	Professional	TC	$76.22	$112.26	$189.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.14 / $47.14 / $47.14	Facility	26	$47.14	$47.14	$47.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.07 / $177.11 / $309.64	Professional		$115.07	$177.11	$309.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.67 / $66.12 / $118.72	Professional	26	$38.67	$66.12	$118.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.03 / $112.08 / $195.29	Professional	TC	$68.03	$112.08	$195.29
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $43.00 / $45.34 / $98.77	Facility	26	$43.00	$45.34	$98.77
Medcost Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $55.00 / $160.00	Professional		$53.00	$55.00	$160.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $43.00 / $45.34 / $150.91	Professional	26	$43.00	$45.34	$150.91
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $180.00 / $183.50 / $664.06	Professional	50	$180.00	$183.50	$664.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.38 / $168.40 / $252.04	Professional		$64.38	$168.40	$252.04
United Facility/Professional Professional Modifier Low / Median / High Price $68.29 / $119.73 / $265.76	Professional		$68.29	$119.73	$265.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.35 / $48.43 / $108.01	Professional	26	$23.35	$48.43	$108.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.94 / $67.88 / $146.91	Professional	TC	$43.94	$67.88	$146.91
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $214.20 / $214.20	Facility	26	$100.00	$214.20	$214.20
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $802.94 / $802.94 / $1,319.18	Professional		$802.94	$802.94	$1,319.18
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $261.89 / $261.89 / $336.38	Professional	26	$261.89	$261.89	$336.38
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $595.82 / $595.82 / $982.73	Professional	TC	$595.82	$595.82	$982.73