Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.33 / $62.71 / $139.18	Facility	26	$37.33	$62.71	$139.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.48 / $176.86 / $559.54	Professional		$75.48	$176.86	$559.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.33 / $59.28 / $164.82	Professional	26	$37.33	$59.28	$164.82
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.74 / $48.93 / $139.04	Professional	52	$37.74	$48.93	$139.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.15 / $95.13 / $186.62	Professional	TC	$38.15	$95.13	$186.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $154.12 / $229.80	Professional		$81.90	$154.12	$229.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.55 / $64.98 / $71.47	Professional	26	$56.55	$64.98	$71.47
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $20.48 / $20.48 / $20.48	Professional	52	$20.48	$20.48	$20.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $78.31 / $78.31 / $78.31	Professional	TC	$78.31	$78.31	$78.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.11 / $163.35 / $199.11	Professional		$132.11	$163.35	$199.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.61 / $85.28 / $201.50	Professional	26	$40.61	$85.28	$201.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.46 / $78.31 / $339.70	Professional	TC	$47.46	$78.31	$339.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.80 / $49.80 / $49.80	Facility	26	$49.80	$49.80	$49.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.93 / $238.62 / $423.63	Professional		$116.93	$238.62	$423.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.09 / $96.07 / $158.69	Professional	26	$51.09	$96.07	$158.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.59 / $131.74 / $261.01	Professional	TC	$60.59	$131.74	$261.01
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $59.29 / $97.46 / $121.26	Facility	26	$59.29	$97.46	$121.26
Medcost Facility/Professional Professional Modifier Low / Median / High Price $73.00 / $135.00 / $212.00	Professional		$73.00	$135.00	$212.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $84.39 / $84.39 / $84.39	Professional	26	$84.39	$84.39	$84.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.61 / $77.09 / $147.91	Professional		$60.61	$77.09	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $107.19 / $181.14 / $318.38	Professional		$107.19	$181.14	$318.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.71 / $73.87 / $132.07	Professional	26	$44.71	$73.87	$132.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.62 / $110.91 / $200.15	Professional	TC	$65.62	$110.91	$200.15
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $127.00 / $333.99 / $333.99	Facility	26	$127.00	$333.99	$333.99
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,000.00 / $3,000.00 / $3,000.00	Professional		$3,000.00	$3,000.00	$3,000.00
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $870.13 / $870.13 / $870.13	Professional	26	$870.13	$870.13	$870.13
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $870.13 / $870.13 / $870.13	Professional	TC	$870.13	$870.13	$870.13