Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.86 / $24.86 / $41.74	Facility	26	$24.86	$24.86	$41.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.65 / $128.19 / $248.59	Professional		$101.65	$128.19	$248.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.36 / $27.87 / $70.95	Professional	26	$23.36	$27.87	$70.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.04 / $103.33 / $204.59	Professional	TC	$69.04	$103.33	$204.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $58.36 / $58.36 / $62.68	Professional	26	$58.36	$58.36	$62.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.75 / $80.75 / $80.75	Professional		$80.75	$80.75	$80.75
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.15 / $64.18 / $87.70	Professional	26	$33.15	$64.18	$87.70
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.99 / $140.62 / $371.97	Professional	TC	$61.99	$140.62	$371.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.43 / $39.43 / $39.43	Facility	26	$39.43	$39.43	$39.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.39 / $247.48 / $403.22	Professional		$169.39	$247.48	$403.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.93 / $42.82 / $64.30	Professional	26	$28.93	$42.82	$64.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.19 / $205.39 / $340.31	Professional	TC	$135.19	$205.39	$340.31
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $32.76 / $53.00 / $67.97	Facility	26	$32.76	$53.00	$67.97
Medcost Facility/Professional Professional Modifier Low / Median / High Price $33.00 / $155.00 / $471.74	Professional		$33.00	$155.00	$471.74
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $32.76 / $32.76 / $53.00	Professional	26	$32.76	$32.76	$53.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $380.25 / $380.25 / $380.25	Professional	TC	$380.25	$380.25	$380.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.57 / $175.96 / $280.00	Professional		$37.57	$175.96	$280.00
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $213.73 / $414.22	Professional		$154.88	$213.73	$414.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.12 / $37.92 / $67.84	Professional	26	$26.12	$37.92	$67.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.76 / $177.68 / $344.80	Professional	TC	$128.76	$177.68	$344.80
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $82.93 / $174.33 / $174.33	Facility	26	$82.93	$174.33	$174.33
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,219.73 / $1,219.73 / $1,341.64	Professional		$1,219.73	$1,219.73	$1,341.64
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $286.73 / $286.73 / $375.24	Professional	26	$286.73	$286.73	$375.24
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $936.06 / $936.06 / $1,120.47	Professional	TC	$936.06	$936.06	$1,120.47