Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $275.42 / $616.60	Facility		$81.28	$275.42	$616.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $11.48 / $31.62	Facility	26	$8.13	$11.48	$31.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.88 / $229.09 / $630.96	Facility	TC	$21.88	$229.09	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $40.74 / $112.20	Professional		$10.47	$40.74	$112.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $14.13 / $46.77	Professional	26	$7.94	$14.13	$46.77
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.20 / $69.18 / $190.55	Professional	50	$30.20	$69.18	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $38.90 / $83.18	Professional	TC	$20.89	$38.90	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $28.84 / $56.23	Professional		$21.38	$28.84	$56.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.55 / $16.98	Professional	26	$7.08	$9.55	$16.98
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.90 / $56.23 / $87.10	Professional	50	$38.90	$56.23	$87.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $24.55 / $38.90	Professional	TC	$17.38	$24.55	$38.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $22.39 / $22.39	Professional		$22.39	$22.39	$22.39
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $20.89 / $26.92	Professional	26	$12.88	$20.89	$26.92
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $38.90 / $57.54	Professional	TC	$32.36	$38.90	$57.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $67.61 / $107.15	Facility		$36.31	$67.61	$107.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	TC	$6.03	$28.18	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $47.86 / $83.18	Professional		$28.84	$47.86	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.49 / $24.55	Professional	26	$8.13	$13.49	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $32.36 / $58.88	Professional	TC	$19.95	$32.36	$58.88
Medcost Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $51.29	Professional		$51.29	$51.29	$51.29
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.22 / $16.22	Professional	26	$16.22	$16.22	$16.22
Medcost Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $44.67 / $72.44	Facility		$29.51	$44.67	$72.44
Medcost Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,122.02 / $2,951.21	Facility		$1,023.29	$1,122.02	$2,951.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $33.88 / $70.79	Professional		$9.55	$33.88	$70.79
United Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $37.15 / $67.61	Facility		$10.72	$37.15	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $38.02 / $69.18	Professional		$28.18	$38.02	$69.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $11.22 / $20.42	Professional	26	$8.71	$11.22	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $26.30 / $48.98	Professional	TC	$19.05	$26.30	$48.98
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $363.08	Facility		$223.87	$223.87	$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 $165.96 / $165.96 / $165.96	Facility	TC	$165.96	$165.96	$165.96
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $295.12	Professional		$223.87	$223.87	$295.12
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $89.13 / $89.13	Professional	26	$89.13	$89.13	$89.13
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $177.83 / $218.78	Professional	TC	$177.83	$177.83	$218.78