Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.70 / $55.75 / $93.50	Facility	26	$55.70	$55.75	$93.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.62 / $98.38 / $261.26	Professional		$83.62	$98.38	$261.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.54 / $57.94 / $129.22	Professional	26	$51.54	$57.94	$129.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.90 / $41.88 / $76.34	Professional	TC	$24.90	$41.88	$76.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.67 / $155.56 / $200.00	Professional		$82.67	$155.56	$200.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $73.09 / $90.20 / $99.98	Professional	26	$73.09	$90.20	$99.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $80.00 / $80.00	Professional		$80.00	$80.00	$80.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.54 / $94.71 / $180.86	Professional	26	$51.54	$94.71	$180.86
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.36 / $52.30 / $65.58	Professional	TC	$37.36	$52.30	$65.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.81 / $62.81 / $62.81	Facility	26	$62.81	$62.81	$62.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.26 / $132.83 / $236.70	Professional		$95.26	$132.83	$236.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.91 / $89.82 / $149.53	Professional	26	$62.91	$89.82	$149.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.47 / $45.01 / $80.84	Professional	TC	$29.47	$45.01	$80.84
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $64.58 / $68.95 / $123.70	Facility	26	$64.58	$68.95	$123.70
Medcost Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $77.00 / $112.00	Professional		$35.00	$77.00	$112.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $25.22 / $25.22 / $25.22	Professional	TC	$25.22	$25.22	$25.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.43 / $87.56 / $154.84	Professional		$61.43	$87.56	$154.84
United Facility/Professional Professional Modifier Low / Median / High Price $76.94 / $98.84 / $200.14	Professional		$76.94	$98.84	$200.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.55 / $66.31 / $119.77	Professional	26	$51.55	$66.31	$119.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.32 / $32.90 / $56.89	Professional	TC	$22.32	$32.90	$56.89
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $100.41 / $129.41 / $270.89	Facility	26	$100.41	$129.41	$270.89
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $746.58 / $746.58 / $795.23	Professional		$746.58	$746.58	$795.23
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $352.29 / $352.29 / $440.48	Professional	26	$352.29	$352.29	$440.48
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $288.04 / $288.04 / $354.75	Professional	TC	$288.04	$288.04	$354.75