Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.69 / $26.71 / $43.81	Facility	26	$24.69	$26.71	$43.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.69 / $115.43 / $331.36	Professional		$90.69	$115.43	$331.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.97 / $28.77 / $98.48	Professional	26	$22.97	$28.77	$98.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.73 / $80.09 / $153.22	Professional	TC	$66.73	$80.09	$153.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.38 / $164.94 / $207.31	Professional		$129.38	$164.94	$207.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.56 / $35.10 / $44.82	Professional	26	$32.56	$35.10	$44.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $94.29 / $94.29 / $120.20	Professional	TC	$94.29	$94.29	$120.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.88 / $68.88 / $68.88	Professional		$68.88	$68.88	$68.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.06 / $55.61 / $76.50	Professional	26	$37.06	$55.61	$76.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.96 / $159.99 / $225.77	Professional	TC	$107.96	$159.99	$225.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.20 / $28.20 / $28.20	Facility	26	$28.20	$28.20	$28.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.35 / $152.57 / $286.79	Professional		$108.35	$152.57	$286.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.67 / $41.03 / $67.79	Professional	26	$27.67	$41.03	$67.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.33 / $111.53 / $208.84	Professional	TC	$78.33	$111.53	$208.84
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $46.00 / $65.59	Facility	26	$29.51	$46.00	$65.59
Medcost Facility/Professional Professional Modifier Low / Median / High Price $33.00 / $124.00 / $351.88	Professional		$33.00	$124.00	$351.88
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $46.00 / $90.86	Professional	26	$29.51	$46.00	$90.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.57 / $109.47 / $168.63	Professional		$35.57	$109.47	$168.63
United Facility/Professional Professional Modifier Low / Median / High Price $94.79 / $131.97 / $262.93	Professional		$94.79	$131.97	$262.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.22 / $34.53 / $67.54	Professional	26	$25.22	$34.53	$67.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.06 / $99.60 / $194.04	Professional	TC	$69.06	$99.60	$194.04
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $119.99 / $136.00	Facility	26	$100.00	$119.99	$136.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $698.76 / $698.76 / $817.73	Professional		$698.76	$698.76	$817.73
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $226.20 / $226.20 / $279.51	Professional	26	$226.20	$226.20	$279.51
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $479.00 / $479.00 / $621.90	Professional	TC	$479.00	$479.00	$621.90