Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.52 / $268.35 / $546.00	Facility		$84.52	$268.35	$546.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.57 / $9.19 / $23.20	Facility	26	$7.57	$9.19	$23.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.00 / $166.52 / $545.94	Facility	TC	$28.00	$166.52	$545.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.34 / $45.80 / $152.58	Professional		$24.34	$45.80	$152.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.57 / $12.86 / $44.56	Professional	26	$7.57	$12.86	$44.56
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.81 / $82.84 / $218.25	Professional	50	$46.81	$82.84	$218.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.18 / $38.07 / $105.42	Professional	TC	$27.18	$38.07	$105.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.70 / $58.35 / $99.27	Professional		$30.70	$58.35	$99.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.25 / $12.89 / $23.63	Professional	26	$6.25	$12.89	$23.63
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $45.84 / $45.84 / $45.84	Professional	50	$45.84	$45.84	$45.84
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.66 / $31.93 / $42.60	Professional	TC	$23.66	$31.93	$42.60
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 $32.54 / $49.24 / $71.47	Professional	TC	$32.54	$49.24	$71.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.23 / $62.23 / $108.10	Facility		$46.23	$62.23	$108.10
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 $36.90 / $36.90 / $36.90	Facility	TC	$36.90	$36.90	$36.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.83 / $51.78 / $95.87	Professional		$29.83	$51.78	$95.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $13.38 / $23.75	Professional	26	$7.93	$13.38	$23.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.03 / $40.79 / $75.27	Professional	TC	$22.03	$40.79	$75.27
Medcost Facility/Professional Facility Modifier Low / Median / High Price $35.58 / $54.00 / $90.51	Facility		$35.58	$54.00	$90.51
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.29 / $15.00 / $25.84	Facility	26	$12.29	$15.00	$25.84
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $33.33 / $51.75 / $82.98	Facility	TC	$33.33	$51.75	$82.98
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $33.00 / $46.68	Professional		$11.00	$33.00	$46.68
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 $70.02 / $81.00 / $218.21	Professional	50	$70.02	$81.00	$218.21
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,015.78 / $1,109.79 / $3,382.02	Facility		$1,015.78	$1,109.79	$3,382.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.17 / $40.52 / $70.08	Professional		$9.17	$40.52	$70.08
United Facility/Professional Professional Modifier Low / Median / High Price $30.34 / $50.06 / $95.24	Professional		$30.34	$50.06	$95.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $11.35 / $21.92	Professional	26	$8.23	$11.35	$21.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.84 / $36.76 / $72.42	Professional	TC	$23.84	$36.76	$72.42
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $87.91 / $359.91 / $359.91	Facility		$87.91	$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 $70.01 / $180.83 / $180.83	Facility	TC	$70.01	$180.83	$180.83
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $263.06 / $263.06 / $348.98	Professional		$263.06	$263.06	$348.98
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $67.70 / $67.70 / $67.73	Professional	26	$67.70	$67.70	$67.73
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $209.88 / $209.88 / $281.25	Professional	TC	$209.88	$209.88	$281.25