Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $245.47 / $549.54	Facility		$64.57	$245.47	$549.54
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 $20.89 / $75.86 / $549.54	Facility	TC	$20.89	$75.86	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $40.74 / $117.49	Professional		$12.30	$40.74	$117.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $14.79 / $42.66	Professional	26	$7.41	$14.79	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.77 / $123.03 / $323.59	Professional	50	$46.77	$123.03	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $41.69 / $83.18	Professional	TC	$19.95	$41.69	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $28.18 / $52.48	Professional		$20.89	$28.18	$52.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $8.91 / $16.98	Professional	26	$6.46	$8.91	$16.98
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $32.36 / $53.70 / $83.18	Professional	50	$32.36	$53.70	$83.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $21.38 / $28.84	Professional	TC	$17.38	$21.38	$28.84
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 / $19.50 / $24.55	Professional	26	$12.02	$19.50	$24.55
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $44.67 / $66.07	Professional	TC	$32.36	$44.67	$66.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $64.57 / $102.33	Facility		$34.67	$64.57	$102.33
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 $5.62 / $26.30 / $38.02	Facility	TC	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $46.77 / $81.28	Professional		$29.51	$46.77	$81.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $12.59 / $22.39	Professional	26	$7.41	$12.59	$22.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $34.67 / $58.88	Professional	TC	$20.42	$34.67	$58.88
Medcost Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Professional		$50.12	$50.12	$50.12
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 $28.18 / $44.67 / $70.79	Facility		$28.18	$44.67	$70.79
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 $1,412.54 / $1,548.82 / $2,951.21	Facility		$1,412.54	$1,548.82	$2,951.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $33.11 / $70.79	Professional		$8.91	$33.11	$70.79
United Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $36.31 / $67.61	Facility		$10.23	$36.31	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $38.02 / $67.61	Professional		$28.84	$38.02	$67.61
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 $20.89 / $26.92 / $48.98	Professional	TC	$20.89	$26.92	$48.98
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $363.08	Facility		$208.93	$208.93	$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 $154.88 / $154.88 / $154.88	Facility	TC	$154.88	$154.88	$154.88
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $275.42	Professional		$208.93	$208.93	$275.42
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Professional	26	$74.13	$74.13	$74.13
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $177.83 / $208.93	Professional	TC	$177.83	$177.83	$208.93