Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.66 / $212.76 / $457.64	Facility		$81.66	$212.76	$457.64
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.71 / $10.48 / $17.87	Facility	26	$9.71	$10.48	$17.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.17 / $272.13 / $604.50	Facility	TC	$31.17	$272.13	$604.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.75 / $44.83 / $153.62	Professional		$24.75	$44.83	$153.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.35 / $11.51 / $44.80	Professional	26	$9.35	$11.51	$44.80
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.08 / $46.08 / $46.08	Professional	50	$46.08	$46.08	$46.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.55 / $35.44 / $95.20	Professional	TC	$27.55	$35.44	$95.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.40 / $75.58 / $88.90	Professional		$35.40	$75.58	$88.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $11.95 / $22.57	Professional	26	$8.02	$11.95	$22.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.53 / $35.82 / $43.44	Professional	TC	$26.53	$35.82	$43.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.90 / $27.90 / $27.90	Professional		$27.90	$27.90	$27.90
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.55 / $25.48 / $31.92	Professional	26	$17.55	$25.48	$31.92
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.81 / $58.03 / $82.11	Professional	TC	$45.81	$58.03	$82.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.97 / $69.29 / $108.10	Facility		$51.97	$69.29	$108.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $41.38 / $41.38 / $41.38	Facility	TC	$41.38	$41.38	$41.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.70 / $62.54 / $114.52	Professional		$36.70	$62.54	$114.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.62 / $17.57 / $30.67	Professional	26	$11.62	$17.57	$30.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.69 / $48.78 / $84.97	Professional	TC	$29.69	$48.78	$84.97
Medcost Facility/Professional Facility Modifier Low / Median / High Price $40.89 / $58.59 / $103.68	Facility		$40.89	$58.59	$103.68
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $16.73 / $16.73 / $27.20	Facility	26	$16.73	$16.73	$27.20
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $40.67 / $50.28 / $97.02	Facility	TC	$40.67	$50.28	$97.02
Medcost Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $38.00 / $58.59	Professional		$14.00	$38.00	$58.59
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $16.73 / $16.73 / $16.73	Professional	26	$16.73	$16.73	$16.73
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $87.89 / $87.89 / $250.77	Professional	50	$87.89	$87.89	$250.77
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $127.51 / $127.51 / $127.51	Professional	TC	$127.51	$127.51	$127.51
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,227.63 / $1,341.25 / $6,443.15	Facility		$1,227.63	$1,341.25	$6,443.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.19 / $46.16 / $81.34	Professional		$11.19	$46.16	$81.34
United Facility/Professional Professional Modifier Low / Median / High Price $39.57 / $55.49 / $105.69	Professional		$39.57	$55.49	$105.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.97 / $14.95 / $27.93	Professional	26	$10.97	$14.95	$27.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.14 / $41.74 / $73.38	Professional	TC	$29.14	$41.74	$73.38
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $94.81 / $359.91 / $359.91	Facility		$94.81	$359.91	$359.91
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $70.00 / $70.00	Facility	26	$50.00	$70.00	$70.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $78.56 / $202.87 / $202.87	Facility	TC	$78.56	$202.87	$202.87
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $301.95 / $401.48 / $401.48	Professional		$301.95	$401.48	$401.48
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $68.20 / $86.33 / $86.33	Professional	26	$68.20	$86.33	$86.33
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $233.75 / $315.14 / $315.14	Professional	TC	$233.75	$315.14	$315.14