Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.29 / $265.68 / $440.71	Facility		$50.29	$265.68	$440.71
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 $25.10 / $363.33 / $632.10	Facility	TC	$25.10	$363.33	$632.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.88 / $43.39 / $147.91	Professional		$31.88	$43.39	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.71 / $11.82 / $39.26	Professional	26	$9.71	$11.82	$39.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.82 / $29.86 / $76.86	Professional	TC	$24.82	$29.86	$76.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.56 / $54.00 / $97.18	Professional		$29.56	$54.00	$97.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $14.22 / $22.57	Professional	26	$8.02	$14.22	$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 $27.78 / $27.78 / $27.78	Professional		$27.78	$27.78	$27.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $23.86 / $31.58	Professional	26	$16.39	$23.86	$31.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.74 / $50.37 / $69.16	Professional	TC	$38.74	$50.37	$69.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.85 / $55.80 / $126.40	Facility		$41.85	$55.80	$126.40
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 $32.79 / $32.79 / $32.79	Facility	TC	$32.79	$32.79	$32.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.69 / $56.50 / $97.44	Professional		$32.69	$56.50	$97.44
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 $24.60 / $40.52 / $68.95	Professional	TC	$24.60	$40.52	$68.95
Medcost Facility/Professional Facility Modifier Low / Median / High Price $34.82 / $60.98 / $92.52	Facility		$34.82	$60.98	$92.52
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $16.26 / $23.00 / $33.10	Facility	26	$16.26	$23.00	$33.10
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $30.65 / $50.02 / $74.06	Facility	TC	$30.65	$50.02	$74.06
Medcost Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $30.00 / $51.00	Professional		$14.00	$30.00	$51.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $16.26 / $23.00 / $39.71	Professional	26	$16.26	$23.00	$39.71
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $254.51 / $278.04 / $1,200.56	Facility		$254.51	$278.04	$1,200.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.09 / $38.47 / $67.72	Professional		$11.09	$38.47	$67.72
United Facility/Professional Professional Modifier Low / Median / High Price $35.25 / $47.23 / $90.85	Professional		$35.25	$47.23	$90.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.88 / $14.34 / $27.93	Professional	26	$10.88	$14.34	$27.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.21 / $34.01 / $60.93	Professional	TC	$24.21	$34.01	$60.93
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 $31.90 / $100.00 / $100.00	Facility	26	$31.90	$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 $256.38 / $256.38 / $333.60	Professional		$256.38	$256.38	$333.60
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $82.56 / $82.56 / $135.00	Professional	26	$82.56	$82.56	$135.00
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $211.00 / $211.00 / $247.28	Professional	TC	$211.00	$211.00	$247.28