Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.36 / $281.32 / $609.84	Facility		$80.36	$281.32	$609.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.16 / $9.88 / $15.04	Facility	26	$8.16	$9.88	$15.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.92 / $270.64 / $609.84	Facility	TC	$21.92	$270.64	$609.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.61 / $40.08 / $100.00	Professional		$19.61	$40.08	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $10.16 / $44.00	Professional	26	$8.11	$10.16	$44.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $32.64 / $65.98 / $180.83	Professional	50	$32.64	$65.98	$180.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $29.57 / $95.00	Professional	TC	$19.14	$29.57	$95.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.13 / $34.71 / $84.12	Professional		$25.13	$34.71	$84.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.75 / $12.91 / $28.26	Professional	26	$6.75	$12.91	$28.26
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.52 / $38.52 / $64.59	Professional	50	$38.52	$38.52	$64.59
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.38 / $24.61 / $38.44	Professional	TC	$18.38	$24.61	$38.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.60 / $22.60 / $22.60	Professional		$22.60	$22.60	$22.60
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.93 / $20.03 / $26.58	Professional	26	$13.93	$20.03	$26.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.72 / $41.78 / $57.06	Professional	TC	$32.72	$41.78	$57.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.54 / $48.74 / $108.10	Facility		$36.54	$48.74	$108.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.43 / $47.50 / $82.47	Professional		$27.43	$47.50	$82.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.31 / $14.57 / $25.64	Professional	26	$8.31	$14.57	$25.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.83 / $33.63 / $58.98	Professional	TC	$20.83	$33.63	$58.98
Medcost Facility/Professional Facility Modifier Low / Median / High Price $30.11 / $49.68 / $81.96	Facility		$30.11	$49.68	$81.96
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $13.67 / $15.00 / $27.88	Facility	26	$13.67	$15.00	$27.88
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $26.55 / $43.97 / $65.17	Facility	TC	$26.55	$43.97	$65.17
Medcost Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $24.00 / $40.04	Professional		$12.00	$24.00	$40.04
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $13.67 / $13.67 / $15.00	Professional	26	$13.67	$13.67	$15.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $60.06 / $87.00 / $184.64	Professional	50	$60.06	$87.00	$184.64
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $89.68 / $89.68 / $89.68	Professional	TC	$89.68	$89.68	$89.68
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,015.78 / $1,111.54 / $3,737.31	Facility		$1,015.78	$1,111.54	$3,737.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.51 / $34.76 / $58.67	Professional		$9.51	$34.76	$58.67
United Facility/Professional Professional Modifier Low / Median / High Price $29.48 / $41.11 / $78.31	Professional		$29.48	$41.11	$78.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $13.25 / $24.41	Professional	26	$9.02	$13.25	$24.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.11 / $30.96 / $53.83	Professional	TC	$20.11	$30.96	$53.83
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $73.69 / $359.91 / $359.91	Facility		$73.69	$359.91	$359.91
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $27.00 / $100.00 / $100.00	Facility	26	$27.00	$100.00	$100.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $54.35 / $140.51 / $140.51	Facility	TC	$54.35	$140.51	$140.51
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $221.82 / $221.82 / $292.13	Professional		$221.82	$221.82	$292.13
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $89.16 / $89.16 / $89.16	Professional	26	$89.16	$89.16	$89.16
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $177.00 / $177.00 / $219.00	Professional	TC	$177.00	$177.00	$219.00