Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $234.42 / $489.78	Facility		$58.88	$234.42	$489.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $9.77 / $23.99	Facility	26	$6.92	$9.77	$23.99
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.62 / $30.20 / $316.23	Facility	TC	$18.62	$30.20	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $34.67 / $89.13	Professional		$12.30	$34.67	$89.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $14.13 / $43.65	Professional	26	$6.92	$14.13	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.11 / $109.65 / $251.19	Professional	50	$33.11	$109.65	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $30.90 / $60.26	Professional	TC	$16.98	$30.90	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $21.88 / $47.86	Professional		$17.38	$21.88	$47.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $7.41 / $14.79	Professional	26	$5.89	$7.41	$14.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $19.50 / $28.84	Professional	TC	$14.45	$19.50	$28.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Professional		$19.95	$19.95	$19.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $17.78 / $23.99	Professional	26	$10.96	$17.78	$23.99
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $34.67 / $50.12	Professional	TC	$28.84	$34.67	$50.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $57.54 / $100.00	Facility		$30.90	$57.54	$100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $12.59	Facility	26	$1.86	$8.71	$12.59
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.01 / $23.44 / $33.88	Facility	TC	$5.01	$23.44	$33.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $41.69 / $72.44	Professional		$25.12	$41.69	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $11.75 / $20.89	Professional	26	$6.92	$11.75	$20.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $28.84 / $51.29	Professional	TC	$17.78	$28.84	$51.29
Medcost Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $44.67	Professional		$44.67	$44.67	$44.67
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $14.13 / $14.13	Professional	26	$14.13	$14.13	$14.13
Medcost Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $38.02 / $60.26	Facility		$25.70	$38.02	$60.26
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 $870.96 / $870.96 / $870.96	Facility		$870.96	$870.96	$870.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $28.84 / $58.88	Professional		$8.13	$28.84	$58.88
United Facility/Professional Facility Modifier Low / Median / High Price $9.55 / $32.36 / $67.61	Facility		$9.55	$32.36	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $33.11 / $60.26	Professional		$25.12	$33.11	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.77 / $17.78	Professional	26	$7.59	$9.77	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $23.44 / $42.66	Professional	TC	$17.38	$23.44	$42.66
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $363.08	Facility		$186.21	$186.21	$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 $138.04 / $138.04 / $138.04	Facility	TC	$138.04	$138.04	$138.04
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $245.47	Professional		$186.21	$186.21	$245.47
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $64.57 / $64.57	Professional	26	$64.57	$64.57	$64.57
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $162.18 / $186.21	Professional	TC	$162.18	$162.18	$186.21