Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.79 / $154.79 / $233.86	Facility	26	$154.79	$154.79	$233.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.78 / $274.20 / $730.93	Professional		$235.78	$274.20	$730.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $142.35 / $154.82 / $339.05	Professional	26	$142.35	$154.82	$339.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.22 / $101.55 / $161.32	Professional	TC	$88.22	$101.55	$161.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $222.38 / $357.39 / $441.53	Professional		$222.38	$357.39	$441.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $143.52 / $217.40 / $275.54	Professional	26	$143.52	$217.40	$275.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $144.47 / $226.82 / $493.44	Professional	26	$144.47	$226.82	$493.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.91 / $116.47 / $310.42	Professional	TC	$78.91	$116.47	$310.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $176.41 / $176.41 / $176.41	Facility	26	$176.41	$176.41	$176.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.94 / $358.60 / $671.74	Professional		$113.94	$358.60	$671.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $167.23 / $242.95 / $425.25	Professional	26	$167.23	$242.95	$425.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.34 / $155.62 / $267.02	Professional	TC	$102.34	$155.62	$267.02
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $179.88 / $275.54 / $421.83	Facility	26	$179.88	$275.54	$421.83
Medcost Facility/Professional Professional Modifier Low / Median / High Price $125.00 / $201.00 / $326.00	Professional		$125.00	$201.00	$326.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $116.47 / $116.47 / $116.47	Professional	TC	$116.47	$116.47	$116.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $123.72 / $237.63 / $435.95	Professional		$123.72	$237.63	$435.95
United Facility/Professional Professional Modifier Low / Median / High Price $248.04 / $317.91 / $643.47	Professional		$248.04	$317.91	$643.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $150.94 / $202.15 / $397.38	Professional	26	$150.94	$202.15	$397.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.17 / $128.55 / $245.41	Professional	TC	$94.17	$128.55	$245.41
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $284.12 / $767.41 / $767.41	Facility	26	$284.12	$767.41	$767.41
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,600.14 / $1,997.93 / $1,997.93	Professional		$1,600.14	$1,997.93	$1,997.93
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $982.86 / $1,248.83 / $1,248.83	Professional	26	$982.86	$1,248.83	$1,248.83
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $617.27 / $749.18 / $749.18	Professional	TC	$617.27	$749.18	$749.18