Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $43.65 / $43.65	Facility	26	$43.65	$43.65	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $85.11 / $151.36	Professional		$72.44	$85.11	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $44.67 / $87.10	Professional	26	$39.81	$44.67	$87.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $41.69 / $69.18	Professional	TC	$34.67	$41.69	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $83.18 / $158.49	Professional		$64.57	$83.18	$158.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $40.74 / $42.66	Professional	26	$40.74	$40.74	$42.66
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $60.26 / $141.25	Professional	26	$40.74	$60.26	$141.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $42.66 / $114.82	Professional	TC	$36.31	$42.66	$114.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $50.12 / $70.79	Facility	26	$10.72	$50.12	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $117.49 / $218.78	Professional		$75.86	$117.49	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $67.61 / $123.03	Professional	26	$41.69	$67.61	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $52.48 / $107.15	Professional	TC	$19.05	$52.48	$107.15
Medcost Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Professional	26	$70.79	$70.79	$70.79
Medcost Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Professional		$53.70	$53.70	$53.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $87.10 / $177.83	Professional		$43.65	$87.10	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $91.20 / $169.82	Professional		$66.07	$91.20	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $51.29 / $91.20	Professional	26	$39.81	$51.29	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $40.74 / $79.43	Professional	TC	$23.44	$40.74	$79.43
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $281.84 / $281.84 / $281.84	Facility	26	$281.84	$281.84	$281.84
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $562.34 / $707.95	Professional		$562.34	$562.34	$707.95
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $316.23 / $316.23 / $346.74	Professional	26	$316.23	$316.23	$346.74
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $316.23 / $363.08	Professional	TC	$316.23	$316.23	$363.08