Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.12 / $244.24 / $543.20	Facility		$65.12	$244.24	$543.20
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 $20.78 / $267.48 / $575.76	Facility	TC	$20.78	$267.48	$575.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.78 / $45.18 / $120.12	Professional		$21.78	$45.18	$120.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $9.82 / $37.18	Professional	26	$7.33	$9.82	$37.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.81 / $128.00 / $176.73	Professional	50	$46.81	$128.00	$176.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.78 / $39.00 / $83.24	Professional	TC	$20.78	$39.00	$83.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.20 / $51.91 / $79.25	Professional		$24.20	$51.91	$79.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.25 / $11.95 / $21.20	Professional	26	$6.25	$11.95	$21.20
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $36.29 / $36.29 / $36.29	Professional	50	$36.29	$36.29	$36.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.42 / $17.85 / $28.32	Professional	TC	$17.42	$17.85	$28.32
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 / $46.22 / $65.31	Professional	TC	$32.67	$46.22	$65.31
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 $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.13 / $50.13 / $82.94	Professional		$30.13	$50.13	$82.94
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 $22.21 / $37.52 / $62.90	Professional	TC	$22.21	$37.52	$62.90
Medcost Facility/Professional Facility Modifier Low / Median / High Price $28.35 / $52.50 / $76.05	Facility		$28.35	$52.50	$76.05
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.29 / $15.00 / $25.46	Facility	26	$12.29	$15.00	$25.46
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $27.22 / $42.03 / $64.79	Facility	TC	$27.22	$42.03	$64.79
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $28.00 / $42.00	Professional		$11.00	$28.00	$42.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $15.00 / $30.95	Professional	26	$12.29	$15.00	$30.95
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $69.29 / $87.00 / $173.88	Professional	50	$69.29	$87.00	$173.88
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,411.36 / $1,542.00 / $2,290.69	Facility		$1,411.36	$1,542.00	$2,290.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $31.61 / $54.25	Professional		$8.71	$31.61	$54.25
United Facility/Professional Professional Modifier Low / Median / High Price $29.50 / $38.96 / $76.92	Professional		$29.50	$38.96	$76.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $11.35 / $21.75	Professional	26	$8.23	$11.35	$21.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.76 / $30.63 / $56.00	Professional	TC	$20.76	$30.63	$56.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $69.39 / $359.91 / $359.91	Facility		$69.39	$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 $208.83 / $208.83 / $275.39	Professional		$208.83	$208.83	$275.39
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