Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.52 / $104.52 / $143.99	Facility	26	$104.52	$104.52	$143.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.37 / $198.72 / $516.08	Professional		$168.37	$198.72	$516.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.29 / $105.91 / $298.25	Professional	26	$96.29	$105.91	$298.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.38 / $79.14 / $131.94	Professional	TC	$70.38	$79.14	$131.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.69 / $270.76 / $324.23	Professional		$158.69	$270.76	$324.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $136.06 / $149.81 / $186.25	Professional	26	$136.06	$149.81	$186.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $96.75 / $151.90 / $332.85	Professional	26	$96.75	$151.90	$332.85
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.82 / $98.63 / $273.31	Professional	TC	$62.82	$98.63	$273.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.19 / $118.19 / $118.19	Facility	26	$118.19	$118.19	$118.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.94 / $260.88 / $484.81	Professional		$113.94	$260.88	$484.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $113.26 / $162.13 / $288.00	Professional	26	$113.26	$162.13	$288.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.97 / $120.71 / $219.32	Professional	TC	$80.97	$120.71	$219.32
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $120.35 / $161.81 / $278.17	Facility	26	$120.35	$161.81	$278.17
Medcost Facility/Professional Professional Modifier Low / Median / High Price $111.00 / $136.00 / $248.00	Professional		$111.00	$136.00	$248.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $88.75 / $88.75 / $88.75	Professional	TC	$88.75	$88.75	$88.75
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $88.60 / $164.55 / $311.66	Professional		$88.60	$164.55	$311.66
United Facility/Professional Professional Modifier Low / Median / High Price $175.25 / $232.09 / $449.56	Professional		$175.25	$232.09	$449.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.73 / $134.12 / $264.64	Professional	26	$100.73	$134.12	$264.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.06 / $97.97 / $184.92	Professional	TC	$74.06	$97.97	$184.92
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $189.04 / $514.76 / $514.76	Facility	26	$189.04	$514.76	$514.76
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,142.65 / $1,428.60 / $1,428.60	Professional		$1,142.65	$1,428.60	$1,428.60
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $663.65 / $833.40 / $833.40	Professional	26	$663.65	$833.40	$833.40
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $479.00 / $595.20 / $595.20	Professional	TC	$479.00	$595.20	$595.20