Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.16 / $59.24 / $96.72	Facility	26	$58.16	$59.24	$96.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.11 / $161.49 / $296.56	Professional		$153.11	$161.49	$296.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $58.16 / $99.31	Professional	26	$53.70	$58.16	$99.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.53 / $103.33 / $206.54	Professional	TC	$99.53	$103.33	$206.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $102.22 / $102.22 / $102.22	Professional	26	$102.22	$102.22	$102.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.90 / $152.90 / $152.90	Professional		$152.90	$152.90	$152.90
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.23 / $123.58 / $153.35	Professional	26	$81.23	$123.58	$153.35
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $103.14 / $189.52 / $285.44	Professional	TC	$103.14	$189.52	$285.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.70 / $66.70 / $66.70	Facility	26	$66.70	$66.70	$66.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $270.69 / $422.55 / $743.80	Professional		$270.69	$422.55	$743.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.27 / $86.58 / $143.07	Professional	26	$58.27	$86.58	$143.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.41 / $334.13 / $595.02	Professional	TC	$208.41	$334.13	$595.02
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $59.70 / $72.14 / $136.87	Facility	26	$59.70	$72.14	$136.87
Medcost Facility/Professional Professional Modifier Low / Median / High Price $76.00 / $336.00 / $594.28	Professional		$76.00	$336.00	$594.28
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $59.70 / $59.70 / $59.70	Professional	26	$59.70	$59.70	$59.70
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $146.90 / $380.25 / $380.25	Professional	TC	$146.90	$380.25	$380.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $84.20 / $303.10 / $509.22	Professional		$84.20	$303.10	$509.22
United Facility/Professional Professional Modifier Low / Median / High Price $252.40 / $369.41 / $790.66	Professional		$252.40	$369.41	$790.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.84 / $74.15 / $147.72	Professional	26	$53.84	$74.15	$147.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $206.60 / $303.43 / $632.62	Professional	TC	$206.60	$303.43	$632.62
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $134.77 / $286.66 / $286.66	Facility	26	$134.77	$286.66	$286.66
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,432.95 / $1,432.95 / $1,779.01	Professional		$1,432.95	$1,432.95	$1,779.01
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $367.94 / $467.10 / $467.10	Professional	26	$367.94	$467.10	$467.10
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,115.23 / $1,115.23 / $1,449.19	Professional	TC	$1,115.23	$1,115.23	$1,449.19