Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.81 / $56.19 / $92.22	Facility	26	$37.81	$56.19	$92.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.55 / $219.03 / $694.50	Professional		$134.55	$219.03	$694.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.11 / $56.89 / $177.60	Professional	26	$35.11	$56.89	$177.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.68 / $151.46 / $252.76	Professional	TC	$99.68	$151.46	$252.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.40 / $136.47 / $269.04	Professional		$114.40	$136.47	$269.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.93 / $41.83 / $79.02	Professional	26	$27.93	$41.83	$79.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $156.91 / $156.91 / $156.91	Professional	TC	$156.91	$156.91	$156.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.75 / $151.75 / $151.75	Professional		$151.75	$151.75	$151.75
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.68 / $120.44 / $148.96	Professional	26	$74.68	$120.44	$148.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $179.39 / $287.30 / $383.65	Professional	TC	$179.39	$287.30	$383.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.24 / $43.24 / $43.24	Facility	26	$43.24	$43.24	$43.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.29 / $271.30 / $404.86	Professional		$173.29	$271.30	$404.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.94 / $73.34 / $109.83	Professional	26	$41.94	$73.34	$109.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.91 / $198.76 / $306.88	Professional	TC	$128.91	$198.76	$306.88
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $61.46 / $100.00 / $108.80	Facility	26	$61.46	$100.00	$108.80
Medcost Facility/Professional Professional Modifier Low / Median / High Price $51.00 / $189.00 / $519.40	Professional		$51.00	$189.00	$519.40
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $63.99 / $63.99 / $100.00	Professional	26	$63.99	$63.99	$100.00
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 $48.25 / $160.43 / $273.85	Professional		$48.25	$160.43	$273.85
United Facility/Professional Professional Modifier Low / Median / High Price $157.32 / $226.56 / $417.66	Professional		$157.32	$226.56	$417.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.64 / $60.66 / $111.50	Professional	26	$39.64	$60.66	$111.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.68 / $164.36 / $318.95	Professional	TC	$117.68	$164.36	$318.95
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $103.49 / $251.76 / $251.76	Facility	26	$103.49	$251.76	$251.76
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,241.41 / $1,241.41 / $1,391.18	Professional		$1,241.41	$1,241.41	$1,391.18
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $315.36 / $315.36 / $344.84	Professional	26	$315.36	$315.36	$344.84
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $934.20 / $934.20 / $1,046.33	Professional	TC	$934.20	$934.20	$1,046.33