Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $213.80 / $616.60	Facility		$50.12	$213.80	$616.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $10.47 / $26.30	Facility	26	$7.59	$10.47	$26.30
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.60 / $27.54 / $363.08	Facility	TC	$16.60	$27.54	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $40.74 / $104.71	Professional		$22.91	$40.74	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.48 / $31.62	Professional	26	$7.08	$11.48	$31.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $25.70 / $61.66	Professional	TC	$15.14	$25.70	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $23.99 / $46.77	Professional		$17.38	$23.99	$46.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $8.51 / $16.22	Professional	26	$6.31	$8.51	$16.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $20.89 / $33.11	Professional	TC	$14.45	$20.89	$33.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Professional		$21.88	$21.88	$21.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $19.95 / $24.55	Professional	26	$12.02	$19.95	$24.55
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $32.36 / $61.66	Professional	TC	$26.30	$32.36	$61.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $52.48 / $120.23	Facility		$28.18	$52.48	$120.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $4.57 / $21.38 / $30.20	Facility	TC	$4.57	$21.38	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $41.69 / $74.13	Professional		$25.70	$41.69	$74.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $12.59 / $22.91	Professional	26	$7.41	$12.59	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $28.18 / $50.12	Professional	TC	$16.22	$28.18	$50.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $45.71	Professional		$45.71	$45.71	$45.71
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $15.49 / $15.49	Professional	26	$15.49	$15.49	$15.49
Medcost Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $38.90 / $63.10	Facility		$24.55	$38.90	$63.10
Medcost Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $34.67	Professional		$34.67	$34.67	$34.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $26.92 / $60.26	Professional		$8.91	$26.92	$60.26
United Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $33.11 / $81.28	Facility		$10.23	$33.11	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $33.11 / $63.10	Professional		$25.12	$33.11	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.47 / $18.62	Professional	26	$8.13	$10.47	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $22.91 / $43.65	Professional	TC	$16.98	$22.91	$43.65
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $363.08	Facility		$177.83	$177.83	$363.08
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	TC	$125.89	$125.89	$125.89
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $234.42	Professional		$177.83	$177.83	$234.42
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Professional	26	$77.62	$77.62	$77.62
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $162.18 / $169.82	Professional	TC	$162.18	$162.18	$169.82