Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $109.65 / $141.25	Facility	26	$83.18	$109.65	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $380.19 / $1,071.52	Professional		$223.87	$380.19	$1,071.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $128.82 / $363.08	Professional	26	$77.62	$128.82	$363.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $181.97 / $380.19	Professional	TC	$141.25	$181.97	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $302.00 / $457.09	Professional		$194.98	$302.00	$457.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $107.15 / $123.03	Professional	26	$81.28	$107.15	$123.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $229.09 / $478.63	Professional		$218.78	$229.09	$478.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $173.78 / $281.84	Professional	26	$125.89	$173.78	$281.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $275.42 / $416.87	Professional	TC	$190.55	$275.42	$416.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $93.33 / $131.83	Facility	26	$19.95	$93.33	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $371.54 / $660.69	Professional		$251.19	$371.54	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $131.83 / $234.42	Professional	26	$91.20	$131.83	$234.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $218.78 / $398.11	Professional	TC	$158.49	$218.78	$398.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $457.09	Professional		$389.05	$389.05	$457.09
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $147.91 / $154.88	Professional	26	$138.04	$147.91	$154.88
Medcost Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Professional		$288.40	$288.40	$288.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $363.08 / $1,023.29	Professional		$138.04	$363.08	$1,023.29
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $295.12 / $524.81	Professional		$223.87	$295.12	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $109.65 / $186.21	Professional	26	$81.28	$109.65	$186.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $181.97 / $346.74	Professional	TC	$138.04	$181.97	$346.74
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $524.81 / $524.81 / $524.81	Facility	26	$524.81	$524.81	$524.81
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $2,398.83	Professional		$2,398.83	$2,398.83	$2,398.83
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $524.81 / $524.81 / $645.65	Professional	26	$524.81	$524.81	$645.65
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $977.24 / $977.24 / $1,258.93	Professional	TC	$977.24	$977.24	$1,258.93