Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.30 / $78.30 / $116.75	Facility	26	$78.30	$78.30	$116.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.16 / $157.27 / $403.00	Professional		$129.16	$157.27	$403.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.04 / $78.64 / $216.33	Professional	26	$72.04	$78.64	$216.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.95 / $61.42 / $103.58	Professional	TC	$53.95	$61.42	$103.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.87 / $186.94 / $242.17	Professional		$169.87	$186.94	$242.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $72.27 / $101.99 / $139.34	Professional	26	$72.27	$101.99	$139.34
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.66 / $114.08 / $249.52	Professional	26	$72.66	$114.08	$249.52
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $49.34 / $69.08 / $210.73	Professional	TC	$49.34	$69.08	$210.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.73 / $88.73 / $88.73	Facility	26	$88.73	$88.73	$88.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.90 / $196.06 / $364.96	Professional		$102.90	$196.06	$364.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.64 / $121.30 / $215.23	Professional	26	$84.64	$121.30	$215.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.25 / $93.60 / $167.93	Professional	TC	$63.25	$93.60	$167.93
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $90.54 / $120.92 / $206.88	Facility	26	$90.54	$120.92	$206.88
Medcost Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $102.00 / $188.00	Professional		$85.00	$102.00	$188.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $68.78 / $68.78 / $68.78	Professional	TC	$68.78	$68.78	$68.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.42 / $124.02 / $238.28	Professional		$66.42	$124.02	$238.28
United Facility/Professional Professional Modifier Low / Median / High Price $133.10 / $177.47 / $342.02	Professional		$133.10	$177.47	$342.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.34 / $100.35 / $198.36	Professional	26	$75.34	$100.35	$198.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.35 / $73.54 / $143.66	Professional	TC	$57.35	$73.54	$143.66
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $141.78 / $386.70 / $386.70	Facility	26	$141.78	$386.70	$386.70
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $874.03 / $1,093.34 / $1,093.34	Professional		$874.03	$1,093.34	$1,093.34
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $497.06 / $625.42 / $625.42	Professional	26	$497.06	$625.42	$625.42
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $376.97 / $467.93 / $467.93	Professional	TC	$376.97	$467.93	$467.93