Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.30 / $287.60 / $544.04	Facility		$83.30	$287.60	$544.04
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 $24.23 / $287.14 / $609.85	Facility	TC	$24.23	$287.14	$609.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.57 / $42.01 / $122.11	Professional		$18.57	$42.01	$122.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $12.10 / $46.81	Professional	26	$7.50	$12.10	$46.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.79 / $68.59 / $191.38	Professional	50	$33.79	$68.59	$191.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.67 / $42.29 / $114.22	Professional	TC	$23.67	$42.29	$114.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.78 / $36.49 / $69.54	Professional		$27.78	$36.49	$69.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.25 / $11.09 / $22.89	Professional	26	$6.25	$11.09	$22.89
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $41.44 / $75.39 / $75.39	Professional	50	$41.44	$75.39	$75.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.78 / $26.99 / $38.72	Professional	TC	$20.78	$26.99	$38.72
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 $31.15 / $45.14 / $62.35	Professional	TC	$31.15	$45.14	$62.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.40 / $53.88 / $108.10	Facility		$40.40	$53.88	$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 $32.44 / $32.44 / $32.44	Facility	TC	$32.44	$32.44	$32.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.73 / $49.93 / $86.61	Professional		$29.73	$49.93	$86.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $13.26 / $23.75	Professional	26	$7.93	$13.26	$23.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.91 / $36.28 / $65.25	Professional	TC	$20.91	$36.28	$65.25
Medcost Facility/Professional Facility Modifier Low / Median / High Price $31.82 / $50.58 / $81.06	Facility		$31.82	$50.58	$81.06
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.29 / $15.00 / $24.00	Facility	26	$12.29	$15.00	$24.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $30.24 / $46.95 / $72.09	Facility	TC	$30.24	$46.95	$72.09
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $27.00 / $42.18	Professional		$11.00	$27.00	$42.18
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $12.29 / $15.00	Professional	26	$12.29	$12.29	$15.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $63.27 / $81.00 / $195.13	Professional	50	$63.27	$81.00	$195.13
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $99.14 / $99.14 / $99.14	Professional	TC	$99.14	$99.14	$99.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.17 / $36.70 / $62.44	Professional		$9.17	$36.70	$62.44
United Facility/Professional Facility Modifier Low / Median / High Price $9.86 / $28.03 / $65.26	Facility		$9.86	$28.03	$65.26
United Facility/Professional Professional Modifier Low / Median / High Price $29.46 / $44.25 / $82.99	Professional		$29.46	$44.25	$82.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.50 / $11.41 / $21.92	Professional	26	$8.50	$11.41	$21.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.54 / $31.49 / $60.17	Professional	TC	$20.54	$31.49	$60.17
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $79.34 / $359.91 / $359.91	Facility		$79.34	$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 $61.48 / $158.84 / $158.84	Facility	TC	$61.48	$158.84	$158.84
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $234.86 / $234.86 / $315.00	Professional		$234.86	$234.86	$315.00
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 $181.68 / $181.68 / $247.28	Professional	TC	$181.68	$181.68	$247.28