Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.64 / $70.69 / $120.69	Facility	26	$68.64	$70.69	$120.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.86 / $214.53 / $938.00	Professional		$183.86	$214.53	$938.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.27 / $80.40 / $303.00	Professional	26	$64.27	$80.40	$303.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.34 / $133.57 / $225.57	Professional	TC	$114.34	$133.57	$225.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $250.00 / $293.62	Professional		$250.00	$250.00	$293.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $90.14 / $123.84 / $124.06	Professional	26	$90.14	$123.84	$124.06
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $152.85 / $152.85 / $194.84	Professional	TC	$152.85	$152.85	$194.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.82 / $188.82 / $188.82	Professional		$188.82	$188.82	$188.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.66 / $153.53 / $234.21	Professional	26	$63.66	$153.53	$234.21
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $103.17 / $233.08 / $435.98	Professional	TC	$103.17	$233.08	$435.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.01 / $78.01 / $78.01	Facility	26	$78.01	$78.01	$78.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.82 / $275.79 / $530.69	Professional		$176.82	$275.79	$530.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.29 / $112.90 / $187.61	Professional	26	$77.29	$112.90	$187.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.31 / $173.99 / $326.75	Professional	TC	$91.31	$173.99	$326.75
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $81.94 / $143.93 / $206.00	Facility	26	$81.94	$143.93	$206.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $211.00 / $676.60	Professional		$90.00	$211.00	$676.60
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $81.94 / $147.00 / $252.60	Professional	26	$81.94	$147.00	$252.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $98.47 / $180.90 / $290.58	Professional		$98.47	$180.90	$290.58
United Facility/Professional Professional Modifier Low / Median / High Price $178.53 / $235.66 / $496.36	Professional		$178.53	$235.66	$496.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.63 / $98.15 / $186.20	Professional	26	$70.63	$98.15	$186.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.30 / $145.96 / $310.38	Professional	TC	$110.30	$145.96	$310.38
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $187.00 / $557.91 / $557.91	Facility	26	$187.00	$557.91	$557.91
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,518.68 / $1,518.68 / $1,677.02	Professional		$1,518.68	$1,518.68	$1,677.02
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $718.23 / $718.23 / $718.23	Professional	26	$718.23	$718.23	$718.23
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $978.30 / $978.30 / $985.97	Professional	TC	$978.30	$978.30	$985.97