Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $208.93 / $575.44	Facility		$53.70	$208.93	$575.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $9.33 / $26.92	Facility	26	$7.94	$9.33	$26.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $14.79 / $165.96 / $398.11	Facility	TC	$14.79	$165.96	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $31.62 / $85.11	Professional		$18.20	$31.62	$85.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.33 / $38.90	Professional	26	$7.59	$9.33	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $18.20 / $43.65	Professional	TC	$10.96	$18.20	$43.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $19.50 / $37.15	Professional		$16.60	$19.50	$37.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $8.71 / $14.45	Professional	26	$6.46	$8.71	$14.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $15.49 / $27.54	Professional	TC	$12.30	$15.49	$27.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $20.89 / $25.70	Professional	26	$12.30	$20.89	$25.70
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $21.38 / $30.20	Professional	TC	$15.85	$21.38	$30.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $40.74 / $100.00	Facility		$24.55	$40.74	$100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.14 / $10.00 / $14.13	Facility	26	$2.14	$10.00	$14.13
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $4.07 / $19.05 / $26.92	Facility	TC	$4.07	$19.05	$26.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $33.88 / $63.10	Professional		$19.95	$33.88	$63.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $13.18 / $23.44	Professional	26	$7.41	$13.18	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $19.50 / $38.90	Professional	TC	$11.75	$19.50	$38.90
Medcost Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $28.18 / $51.29	Facility		$21.38	$28.18	$51.29
Medcost Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $17.38 / $17.38	Professional		$17.38	$17.38	$17.38
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $3,630.78 / $3,630.78	Facility		$3,630.78	$3,630.78	$3,630.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $23.44 / $46.77	Professional		$8.71	$23.44	$46.77
United Facility/Professional Facility Modifier Low / Median / High Price $11.22 / $23.99 / $91.20	Facility		$11.22	$23.99	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $27.54 / $50.12	Professional		$19.05	$27.54	$50.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.48 / $19.05	Professional	26	$8.51	$11.48	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.23 / $16.60 / $31.62	Professional	TC	$10.23	$16.60	$31.62
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $363.08	Facility		$165.96	$165.96	$363.08
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	TC	$109.65	$109.65	$109.65
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $218.78	Professional		$165.96	$165.96	$218.78
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $54.95 / $70.79	Professional	26	$54.95	$54.95	$70.79
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $109.65 / $147.91	Professional	TC	$109.65	$109.65	$147.91