Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.45 / $82.46 / $211.22	Facility	26	$82.45	$82.46	$211.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.72 / $294.22 / $969.00	Professional		$220.72	$294.22	$969.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.65 / $97.12 / $253.50	Professional	26	$76.65	$97.12	$253.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.07 / $165.09 / $318.91	Professional	TC	$144.07	$165.09	$318.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.01 / $393.91 / $452.52	Professional		$309.01	$393.91	$452.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $107.00 / $116.39 / $148.61	Professional	26	$107.00	$116.39	$148.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.86 / $227.25 / $475.84	Professional		$218.86	$227.25	$475.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $140.90 / $190.89 / $259.97	Professional	26	$140.90	$190.89	$259.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $202.54 / $285.54 / $419.40	Professional	TC	$202.54	$285.54	$419.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.46 / $93.46 / $93.46	Facility	26	$93.46	$93.46	$93.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.27 / $390.06 / $672.35	Professional		$263.27	$390.06	$672.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.73 / $138.93 / $224.77	Professional	26	$92.73	$138.93	$224.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.09 / $218.47 / $412.44	Professional	TC	$157.09	$218.47	$412.44
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $99.99 / $109.08 / $183.00	Facility	26	$99.99	$109.08	$183.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $108.00 / $249.56 / $839.44	Professional		$108.00	$249.56	$839.44
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $99.99 / $99.99 / $109.08	Professional	26	$99.99	$99.99	$109.08
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $535.99 / $535.99 / $535.99	Professional	TC	$535.99	$535.99	$535.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.96 / $231.80 / $377.10	Professional		$117.96	$231.80	$377.10
United Facility/Professional Professional Modifier Low / Median / High Price $226.38 / $325.83 / $664.20	Professional		$226.38	$325.83	$664.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.30 / $121.81 / $225.99	Professional	26	$84.30	$121.81	$225.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.11 / $194.97 / $395.97	Professional	TC	$141.11	$194.97	$395.97
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $192.51 / $399.24 / $399.24	Facility	26	$192.51	$399.24	$399.24
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,380.40 / $2,380.40 / $2,380.40	Professional		$2,380.40	$2,380.40	$2,380.40
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $520.19 / $647.63 / $647.63	Professional	26	$520.19	$647.63	$647.63
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $982.86 / $1,266.38 / $1,266.38	Professional	TC	$982.86	$1,266.38	$1,266.38