Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.28 / $215.48 / $444.96	Facility		$62.28	$215.48	$444.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.80 / $11.74 / $17.87	Facility	26	$8.80	$11.74	$17.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.91 / $376.85 / $474.82	Facility	TC	$19.91	$376.85	$474.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.71 / $39.20 / $115.13	Professional		$28.71	$39.20	$115.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $10.84 / $30.91	Professional	26	$8.77	$10.84	$30.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.91 / $23.80 / $60.36	Professional	TC	$19.91	$23.80	$60.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.66 / $33.11 / $80.25	Professional		$24.66	$33.11	$80.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.26 / $14.98 / $24.63	Professional	26	$7.26	$14.98	$24.63
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.71 / $17.75 / $36.75	Professional	TC	$16.71	$17.75	$36.75
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 $16.30 / $23.39 / $31.58	Professional	26	$16.30	$23.39	$31.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.46 / $44.99 / $64.09	Professional	TC	$36.46	$44.99	$64.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.18 / $44.24 / $126.40	Facility		$33.18	$44.24	$126.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.16 / $11.16 / $11.16	Facility	26	$11.16	$11.16	$11.16
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.10 / $26.10 / $26.10	Facility	TC	$26.10	$26.10	$26.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.61 / $50.19 / $87.03	Professional		$27.61	$50.19	$87.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $16.71 / $29.32	Professional	26	$9.78	$16.71	$29.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.54 / $34.77 / $58.61	Professional	TC	$21.54	$34.77	$58.61
Medcost Facility/Professional Facility Modifier Low / Median / High Price $28.71 / $57.00 / $84.73	Facility		$28.71	$57.00	$84.73
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.93 / $18.00 / $30.64	Facility	26	$15.93	$18.00	$30.64
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $26.10 / $43.51 / $60.34	Facility	TC	$26.10	$43.51	$60.34
Medcost Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $28.00 / $42.00	Professional		$14.00	$28.00	$42.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $15.93 / $15.93 / $18.00	Professional	26	$15.93	$15.93	$18.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $81.40 / $81.40 / $81.40	Professional	TC	$81.40	$81.40	$81.40
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $254.51 / $278.04 / $1,293.92	Facility		$254.51	$278.04	$1,293.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.18 / $31.69 / $55.71	Professional		$10.18	$31.69	$55.71
United Facility/Professional Professional Modifier Low / Median / High Price $30.28 / $43.03 / $79.16	Professional		$30.28	$43.03	$79.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.18 / $14.27 / $26.10	Professional	26	$10.18	$14.27	$26.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.17 / $29.63 / $55.16	Professional	TC	$20.17	$29.63	$55.16
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $80.98 / $359.91 / $359.91	Facility		$80.98	$359.91	$359.91
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $31.90 / $100.00 / $100.00	Facility	26	$31.90	$100.00	$100.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $49.38 / $127.63 / $127.63	Facility	TC	$49.38	$127.63	$127.63
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $218.00 / $218.00 / $277.50	Professional		$218.00	$218.00	$277.50
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $87.52 / $87.52 / $87.52	Professional	26	$87.52	$87.52	$87.52
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $199.20 / $206.00 / $206.00	Professional	TC	$199.20	$206.00	$206.00