Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.05 / $212.56 / $410.30	Facility		$45.05	$212.56	$410.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.25 / $8.44 / $13.19	Facility	26	$7.25	$8.44	$13.19
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.48 / $26.61 / $231.44	Facility	TC	$17.48	$26.61	$231.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.76 / $38.24 / $124.38	Professional		$23.76	$38.24	$124.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $9.10 / $46.08	Professional	26	$7.03	$9.10	$46.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.80 / $96.04 / $170.99	Professional	50	$42.80	$96.04	$170.99
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.75 / $13.59 / $87.13	Professional	52	$12.75	$13.59	$87.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.14 / $23.06 / $91.14	Professional	TC	$18.14	$23.06	$91.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.39 / $50.13 / $75.98	Professional		$23.39	$50.13	$75.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.01 / $9.55 / $25.11	Professional	26	$6.01	$9.55	$25.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $41.79 / $41.79 / $41.79	Professional	TC	$41.79	$41.79	$41.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.85 / $19.85 / $19.85	Professional		$19.85	$19.85	$19.85
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.09 / $17.53 / $23.59	Professional	26	$12.09	$17.53	$23.59
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.98 / $38.15 / $53.94	Professional	TC	$27.98	$38.15	$53.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.18 / $44.24 / $126.40	Facility		$33.18	$44.24	$126.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.47 / $26.47 / $26.47	Facility	TC	$26.47	$26.47	$26.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.13 / $43.64 / $73.95	Professional		$26.13	$43.64	$73.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.20 / $12.37 / $21.78	Professional	26	$7.20	$12.37	$21.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $30.52 / $54.50	Professional	TC	$18.48	$30.52	$54.50
Medcost Facility/Professional Facility Modifier Low / Median / High Price $27.17 / $40.00 / $72.91	Facility		$27.17	$40.00	$72.91
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $11.27 / $14.00 / $22.88	Facility	26	$11.27	$14.00	$22.88
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $26.10 / $39.82 / $60.21	Facility	TC	$26.10	$39.82	$60.21
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $22.00 / $36.14	Professional		$11.00	$22.00	$36.14
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $11.27 / $11.27 / $14.00	Professional	26	$11.27	$11.27	$14.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $54.21 / $60.00 / $166.65	Professional	50	$54.21	$60.00	$166.65
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $81.40 / $81.40 / $81.40	Professional	TC	$81.40	$81.40	$81.40
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $278.04 / $278.04 / $278.04	Facility		$278.04	$278.04	$278.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.50 / $30.41 / $51.59	Professional		$8.50	$30.41	$51.59
United Facility/Professional Facility Modifier Low / Median / High Price $65.26 / $65.26 / $65.26	Facility		$65.26	$65.26	$65.26
United Facility/Professional Professional Modifier Low / Median / High Price $26.38 / $39.97 / $74.81	Professional		$26.38	$39.97	$74.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.73 / $10.95 / $20.85	Professional	26	$7.73	$10.95	$20.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.64 / $27.99 / $53.81	Professional	TC	$18.64	$27.99	$53.81
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $66.52 / $359.91 / $359.91	Facility		$66.52	$359.91	$359.91
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $19.63 / $100.00 / $100.00	Facility	26	$19.63	$100.00	$100.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $49.38 / $127.63 / $127.63	Facility	TC	$49.38	$127.63	$127.63
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $200.17 / $200.17 / $264.38	Professional		$200.17	$200.17	$264.38
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $61.09 / $61.09 / $65.18	Professional	26	$61.09	$61.09	$65.18
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $154.00 / $154.00 / $199.20	Professional	TC	$154.00	$154.00	$199.20