Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $69.18 / $109.65	Facility	26	$42.66	$69.18	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $380.19	Professional		$128.82	$162.18	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $56.23 / $151.36	Professional	26	$41.69	$56.23	$151.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $107.15 / $245.47	Professional	TC	$87.10	$107.15	$245.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $45.71 / $97.72	Professional	26	$31.62	$45.71	$97.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $95.50 / $147.91	Professional	26	$63.10	$95.50	$147.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $218.78 / $346.74	Professional	TC	$141.25	$218.78	$346.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $48.98 / $70.79	Facility	26	$10.47	$48.98	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $234.42 / $371.54	Professional		$147.91	$234.42	$371.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $67.61 / $120.23	Professional	26	$47.86	$67.61	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $165.96 / $263.03	Professional	TC	$102.33	$165.96	$263.03
Medcost Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $281.84	Professional		$275.42	$275.42	$281.84
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $70.79 / $81.28	Professional	26	$69.18	$70.79	$81.28
Medcost Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Professional		$194.98	$194.98	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $229.09 / $489.78	Professional		$72.44	$229.09	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $186.21 / $309.03	Professional		$125.89	$186.21	$309.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $54.95 / $97.72	Professional	26	$42.66	$54.95	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $125.89 / $218.78	Professional	TC	$81.28	$125.89	$218.78
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $275.42 / $275.42 / $275.42	Facility	26	$275.42	$275.42	$275.42
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,122.02	Professional		$1,096.48	$1,096.48	$1,122.02
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Professional	26	$446.68	$446.68	$446.68
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $891.25 / $891.25 / $891.25	Professional	TC	$891.25	$891.25	$891.25