Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.84 / $303.86 / $695.07	Facility		$130.84	$303.86	$695.07
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.73 / $22.55 / $36.09	Facility	26	$21.73	$22.55	$36.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.85 / $178.25 / $346.21	Professional		$120.85	$178.25	$346.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.84 / $21.73 / $47.71	Professional	26	$19.84	$21.73	$47.71
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $61.19 / $62.05 / $106.34	Professional	52	$61.19	$62.05	$106.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.37 / $136.72 / $200.42	Professional	TC	$102.37	$136.72	$200.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.53 / $161.72 / $230.72	Professional		$93.53	$161.72	$230.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.89 / $32.22 / $38.40	Professional	26	$24.89	$32.22	$38.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.92 / $57.92 / $57.92	Professional		$57.92	$57.92	$57.92
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.53 / $41.47 / $72.02	Professional	26	$19.53	$41.47	$72.02
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.39 / $153.02 / $367.15	Professional	TC	$97.39	$153.02	$367.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $145.77 / $176.67 / $284.33	Facility		$145.77	$176.67	$284.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.72 / $24.72 / $24.72	Facility	26	$24.72	$24.72	$24.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.65 / $220.72 / $337.14	Professional		$140.65	$220.72	$337.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.03 / $32.88 / $53.16	Professional	26	$22.03	$32.88	$53.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $116.41 / $186.57 / $281.01	Professional	TC	$116.41	$186.57	$281.01
Medcost Facility/Professional Facility Modifier Low / Median / High Price $124.10 / $204.61 / $318.10	Facility		$124.10	$204.61	$318.10
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $23.63 / $39.00 / $56.02	Facility	26	$23.63	$39.00	$56.02
Medcost Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $167.00 / $456.69	Professional		$28.00	$167.00	$456.69
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $23.63 / $23.63 / $39.00	Professional	26	$23.63	$23.63	$39.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $376.72 / $376.72 / $376.72	Professional	TC	$376.72	$376.72	$376.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.91 / $136.41 / $223.85	Professional		$26.91	$136.41	$223.85
United Facility/Professional Professional Modifier Low / Median / High Price $126.23 / $193.15 / $332.57	Professional		$126.23	$193.15	$332.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.72 / $29.04 / $57.78	Professional	26	$20.72	$29.04	$57.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.26 / $160.63 / $277.11	Professional	TC	$104.26	$160.63	$277.11
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $272.45 / $696.92 / $696.92	Facility		$272.45	$696.92	$696.92
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $176.87 / $176.87	Facility	26	$100.00	$176.87	$176.87
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,098.83 / $1,098.83 / $1,205.33	Professional		$1,098.83	$1,098.83	$1,205.33
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $310.41 / $310.41 / $310.41	Professional	26	$310.41	$310.41	$310.41
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $925.73 / $925.73 / $1,077.52	Professional	TC	$925.73	$925.73	$1,077.52