Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.12 / $251.98 / $456.98	Facility		$75.12	$251.98	$456.98
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.71 / $11.74 / $17.87	Facility	26	$9.71	$11.74	$17.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.82 / $264.29 / $503.94	Facility	TC	$24.82	$264.29	$503.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $43.07 / $116.18	Professional		$32.36	$43.07	$116.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.71 / $11.98 / $33.03	Professional	26	$9.71	$11.98	$33.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.25 / $29.86 / $74.08	Professional	TC	$24.25	$29.86	$74.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.56 / $55.06 / $96.39	Professional		$29.56	$55.06	$96.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.97 / $16.55 / $22.57	Professional	26	$7.97	$16.55	$22.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.78 / $30.15 / $38.72	Professional	TC	$20.78	$30.15	$38.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.20 / $27.20 / $27.20	Professional		$27.20	$27.20	$27.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $23.39 / $31.58	Professional	26	$16.39	$23.39	$31.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.85 / $49.78 / $64.86	Professional	TC	$34.85	$49.78	$64.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.37 / $55.16 / $108.10	Facility		$41.37	$55.16	$108.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.44 / $32.44 / $32.44	Facility	TC	$32.44	$32.44	$32.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.68 / $54.30 / $95.89	Professional		$32.68	$54.30	$95.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $17.42 / $30.67	Professional	26	$9.78	$17.42	$30.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.40 / $38.92 / $68.17	Professional	TC	$23.40	$38.92	$68.17
Medcost Facility/Professional Facility Modifier Low / Median / High Price $34.53 / $56.00 / $92.52	Facility		$34.53	$56.00	$92.52
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $16.26 / $18.00 / $33.13	Facility	26	$16.26	$18.00	$33.13
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $32.45 / $49.70 / $74.06	Facility	TC	$32.45	$49.70	$74.06
Medcost Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $27.00 / $50.16	Professional		$14.00	$27.00	$50.16
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $16.26 / $18.00 / $39.71	Professional	26	$16.26	$18.00	$39.71
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $211.85 / $231.46 / $1,559.47	Facility		$211.85	$231.46	$1,559.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.80 / $37.86 / $66.63	Professional		$10.80	$37.86	$66.63
United Facility/Professional Facility Modifier Low / Median / High Price $65.26 / $65.26 / $194.81	Facility		$65.26	$65.26	$194.81
United Facility/Professional Professional Modifier Low / Median / High Price $34.44 / $50.38 / $90.85	Professional		$34.44	$50.38	$90.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.88 / $14.67 / $27.31	Professional	26	$10.88	$14.67	$27.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.26 / $31.57 / $60.20	Professional	TC	$23.26	$31.57	$60.20
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $84.50 / $359.91 / $359.91	Facility		$84.50	$359.91	$359.91
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $25.22 / $100.00 / $100.00	Facility	26	$25.22	$100.00	$100.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $61.48 / $158.84 / $158.84	Facility	TC	$61.48	$158.84	$158.84
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $254.22 / $254.22 / $333.60	Professional		$254.22	$254.22	$333.60
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $90.81 / $90.81 / $120.00	Professional	26	$90.81	$90.81	$120.00
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $195.00 / $195.00 / $247.28	Professional	TC	$195.00	$195.00	$247.28