Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.59 / $215.48 / $408.37	Facility		$63.59	$215.48	$408.37
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.96 / $8.77 / $13.34	Facility	26	$6.96	$8.77	$13.34
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.29 / $38.08 / $315.20	Facility	TC	$20.29	$38.08	$315.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.47 / $33.35 / $87.05	Professional		$20.47	$33.35	$87.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.96 / $8.51 / $33.35	Professional	26	$6.96	$8.51	$33.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.27 / $23.48 / $62.46	Professional	TC	$19.27	$23.48	$62.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.87 / $44.31 / $44.31	Professional		$23.87	$44.31	$44.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.73 / $11.86 / $25.11	Professional	26	$5.73	$11.86	$25.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.85 / $17.85 / $17.85	Professional	TC	$17.85	$17.85	$17.85
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 / $23.59	Professional	26	$13.22	$18.79	$23.59
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.67 / $41.14 / $57.06	Professional	TC	$32.67	$41.14	$57.06
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 $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
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 $29.04 / $46.25 / $79.61	Professional		$29.04	$46.25	$79.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $13.25 / $22.99	Professional	26	$7.93	$13.25	$22.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.22 / $32.65 / $57.19	Professional	TC	$20.22	$32.65	$57.19
Medcost Facility/Professional Facility Modifier Low / Median / High Price $27.75 / $49.00 / $75.59	Facility		$27.75	$49.00	$75.59
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.63 / $15.00 / $24.78	Facility	26	$12.63	$15.00	$24.78
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $26.39 / $34.29 / $63.19	Facility	TC	$26.39	$34.29	$63.19
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $26.00 / $39.02	Professional		$11.00	$26.00	$39.02
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $12.63 / $15.00 / $28.52	Professional	26	$12.63	$15.00	$28.52
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $667.62 / $667.62 / $2,572.63	Facility		$667.62	$667.62	$2,572.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.50 / $32.65 / $53.85	Professional		$8.50	$32.65	$53.85
United Facility/Professional Professional Modifier Low / Median / High Price $28.03 / $41.01 / $73.37	Professional		$28.03	$41.01	$73.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $11.78 / $21.89	Professional	26	$8.23	$11.78	$21.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $29.52 / $54.67	Professional	TC	$19.80	$29.52	$54.67
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $68.72 / $359.91 / $359.91	Facility		$68.72	$359.91	$359.91
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $24.54 / $100.00 / $100.00	Facility	26	$24.54	$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 $204.50 / $204.50 / $270.00	Professional		$204.50	$204.50	$270.00
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $74.30 / $74.30 / $74.30	Professional	26	$74.30	$74.30	$74.30
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $176.00 / $176.00 / $207.68	Professional	TC	$176.00	$176.00	$207.68