Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.76 / $38.29 / $55.93	Facility	26	$29.76	$38.29	$55.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.44 / $212.83 / $548.54	Professional		$170.44	$212.83	$548.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.21 / $38.29 / $105.02	Professional	26	$31.21	$38.29	$105.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.25 / $169.16 / $323.27	Professional	TC	$144.25	$169.16	$323.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $135.59 / $260.47 / $336.74	Professional		$135.59	$260.47	$336.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.96 / $50.34 / $76.09	Professional	26	$27.96	$50.34	$76.09
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $110.03 / $206.45 / $263.17	Professional	TC	$110.03	$206.45	$263.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.15 / $77.15 / $77.15	Professional		$77.15	$77.15	$77.15
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.68 / $64.68 / $108.57	Professional	26	$43.68	$64.68	$108.57
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $204.49 / $288.45 / $383.65	Professional	TC	$204.49	$288.45	$383.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.27 / $43.27 / $43.27	Facility	26	$43.27	$43.27	$43.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.06 / $316.95 / $495.85	Professional		$204.06	$316.95	$495.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.35 / $50.14 / $87.89	Professional	26	$33.35	$50.14	$87.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $164.38 / $269.31 / $393.43	Professional	TC	$164.38	$269.31	$393.43
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $31.98 / $82.19 / $123.00	Facility	26	$31.98	$82.19	$123.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $51.00 / $203.00 / $686.69	Professional		$51.00	$203.00	$686.69
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $31.98 / $89.00 / $140.94	Professional	26	$31.98	$89.00	$140.94
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.01 / $203.72 / $324.95	Professional		$54.01	$203.72	$324.95
United Facility/Professional Professional Modifier Low / Median / High Price $190.82 / $267.42 / $461.11	Professional		$190.82	$267.42	$461.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.11 / $44.86 / $98.03	Professional	26	$29.11	$44.86	$98.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.25 / $222.17 / $381.12	Professional	TC	$151.25	$222.17	$381.12
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $87.82 / $189.47 / $210.00	Facility	26	$87.82	$189.47	$210.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,580.85 / $1,580.85 / $1,625.38	Professional		$1,580.85	$1,580.85	$1,625.38
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $422.69 / $422.69 / $422.69	Professional	26	$422.69	$422.69	$422.69
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,276.50 / $1,276.50 / $1,453.51	Professional	TC	$1,276.50	$1,276.50	$1,453.51