Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.04 / $129.81 / $179.92	Facility	26	$122.04	$129.81	$179.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $203.03 / $256.43 / $606.91	Professional		$203.03	$256.43	$606.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.34 / $132.43 / $342.24	Professional	26	$120.34	$132.43	$342.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.01 / $91.37 / $148.97	Professional	TC	$79.01	$91.37	$148.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $191.66 / $305.10 / $388.92	Professional		$191.66	$305.10	$388.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $182.41 / $232.12 / $232.52	Professional	26	$182.41	$232.12	$232.52
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.76 / $189.59 / $415.43	Professional	26	$120.76	$189.59	$415.43
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.90 / $111.31 / $308.30	Professional	TC	$70.90	$111.31	$308.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.65 / $147.65 / $147.65	Facility	26	$147.65	$147.65	$147.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.94 / $312.92 / $582.16	Professional		$113.94	$312.92	$582.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.31 / $202.63 / $356.79	Professional	26	$140.31	$202.63	$356.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.03 / $139.41 / $246.32	Professional	TC	$93.03	$139.41	$246.32
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $150.16 / $201.31 / $345.47	Facility	26	$150.16	$201.31	$345.47
Medcost Facility/Professional Professional Modifier Low / Median / High Price $125.00 / $170.00 / $295.00	Professional		$125.00	$170.00	$295.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $380.90 / $380.90 / $380.90	Professional	50	$380.90	$380.90	$380.90
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $102.95 / $102.95 / $102.95	Professional	TC	$102.95	$102.95	$102.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $109.87 / $198.63 / $374.28	Professional		$109.87	$198.63	$374.28
United Facility/Professional Professional Modifier Low / Median / High Price $212.34 / $281.23 / $546.92	Professional		$212.34	$281.23	$546.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $125.88 / $165.00 / $331.10	Professional	26	$125.88	$165.00	$331.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.82 / $113.61 / $215.83	Professional	TC	$85.82	$113.61	$215.83
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $236.87 / $642.01 / $642.01	Facility	26	$236.87	$642.01	$642.01
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,374.92 / $1,714.13 / $1,714.13	Professional		$1,374.92	$1,714.13	$1,714.13
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $824.31 / $1,042.50 / $1,042.50	Professional	26	$824.31	$1,042.50	$1,042.50
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $550.61 / $671.63 / $671.63	Professional	TC	$550.61	$671.63	$671.63