Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.26 / $199.26 / $336.99	Facility		$35.26	$199.26	$336.99
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.57 / $9.14 / $13.92	Facility	26	$7.57	$9.14	$13.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.57 / $34.84 / $807.55	Facility	TC	$19.57	$34.84	$807.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.21 / $39.78 / $118.15	Professional		$27.21	$39.78	$118.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.30 / $8.25 / $24.34	Professional	26	$7.30	$8.25	$24.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $24.25 / $61.55	Professional	TC	$19.50	$24.25	$61.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.37 / $46.17 / $59.18	Professional		$24.37	$46.17	$59.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.25 / $12.89 / $26.19	Professional	26	$6.25	$12.89	$26.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $52.27 / $52.27 / $52.27	Professional	TC	$52.27	$52.27	$52.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.65 / $21.65 / $21.65	Professional		$21.65	$21.65	$21.65
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.22 / $18.79 / $24.59	Professional	26	$13.22	$18.79	$24.59
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.67 / $40.47 / $56.44	Professional	TC	$32.67	$40.47	$56.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.63 / $46.17 / $103.46	Facility		$34.63	$46.17	$103.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.22 / $27.22 / $27.22	Facility	TC	$27.22	$27.22	$27.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.60 / $47.25 / $79.67	Professional		$29.60	$47.25	$79.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $13.26 / $23.38	Professional	26	$7.93	$13.26	$23.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.58 / $32.69 / $57.17	Professional	TC	$20.58	$32.69	$57.17
Medcost Facility/Professional Facility Modifier Low / Median / High Price $28.35 / $49.00 / $77.14	Facility		$28.35	$49.00	$77.14
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.29 / $15.00 / $25.84	Facility	26	$12.29	$15.00	$25.84
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $27.22 / $44.08 / $62.19	Facility	TC	$27.22	$44.08	$62.19
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $24.00 / $40.00	Professional		$11.00	$24.00	$40.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $15.00 / $30.95	Professional	26	$12.29	$15.00	$30.95
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $231.46 / $231.46 / $231.46	Facility		$231.46	$231.46	$231.46
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.83 / $30.84 / $53.75	Professional		$8.83	$30.84	$53.75
United Facility/Professional Professional Modifier Low / Median / High Price $27.72 / $38.72 / $73.37	Professional		$27.72	$38.72	$73.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.50 / $11.98 / $21.75	Professional	26	$8.50	$11.98	$21.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $27.85 / $50.55	Professional	TC	$19.48	$27.85	$50.55
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $73.63 / $359.91 / $359.91	Facility		$73.63	$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 $51.52 / $133.13 / $133.13	Facility	TC	$51.52	$133.13	$133.13
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $208.83 / $208.83 / $275.39	Professional		$208.83	$208.83	$275.39
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $82.56 / $82.56 / $82.56	Professional	26	$82.56	$82.56	$82.56
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $176.00 / $176.00 / $207.68	Professional	TC	$176.00	$176.00	$207.68