Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.70 / $215.48 / $483.00	Facility		$72.70	$215.48	$483.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.87 / $8.82 / $15.04	Facility	26	$7.87	$8.82	$15.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.75 / $34.64 / $304.92	Facility	TC	$22.75	$34.64	$304.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.92 / $34.45 / $129.47	Professional		$18.92	$34.45	$129.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $9.44 / $40.00	Professional	26	$7.79	$9.44	$40.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.72 / $50.68 / $135.55	Professional	50	$38.72	$50.68	$135.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.24 / $26.02 / $70.47	Professional	TC	$21.24	$26.02	$70.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.42 / $86.52 / $86.52	Professional		$26.42	$86.52	$86.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.51 / $13.41 / $22.08	Professional	26	$6.51	$13.41	$22.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.48 / $23.48 / $23.48	Professional		$23.48	$23.48	$23.48
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.55 / $21.44 / $26.86	Professional	26	$14.55	$21.44	$26.86
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.88 / $44.19 / $63.62	Professional	TC	$34.88	$44.19	$63.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.00 / $50.67 / $108.10	Facility		$38.00	$50.67	$108.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $30.20 / $30.20	Facility	TC	$30.20	$30.20	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.65 / $51.14 / $87.83	Professional		$31.65	$51.14	$87.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.51 / $14.78 / $24.91	Professional	26	$9.51	$14.78	$24.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.31 / $36.64 / $63.46	Professional	TC	$22.31	$36.64	$63.46
Medcost Facility/Professional Facility Modifier Low / Median / High Price $30.68 / $45.96 / $81.15	Facility		$30.68	$45.96	$81.15
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $14.41 / $20.51 / $26.90	Facility	26	$14.41	$20.51	$26.90
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $31.24 / $31.88 / $53.73	Facility	TC	$31.24	$31.88	$53.73
Medcost Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $29.00 / $45.96	Professional		$12.00	$29.00	$45.96
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $68.94 / $68.94 / $188.18	Professional	50	$68.94	$68.94	$188.18
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $31.88 / $31.88 / $93.21	Professional	TC	$31.88	$31.88	$93.21
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $257.58 / $257.58 / $2,457.41	Facility		$257.58	$257.58	$2,457.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.35 / $36.70 / $60.85	Professional		$12.35	$36.70	$60.85
United Facility/Professional Professional Modifier Low / Median / High Price $31.25 / $46.55 / $80.44	Professional		$31.25	$46.55	$80.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.92 / $12.81 / $23.50	Professional	26	$8.92	$12.81	$23.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.27 / $30.23 / $55.81	Professional	TC	$22.27	$30.23	$55.81
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $75.83 / $359.91 / $359.91	Facility		$75.83	$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 $57.20 / $147.82 / $147.82	Facility	TC	$57.20	$147.82	$147.82
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $226.14 / $300.68 / $300.68	Professional		$226.14	$300.68	$300.68
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $55.28 / $70.34 / $70.34	Professional	26	$55.28	$70.34	$70.34
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $170.86 / $230.33 / $230.33	Professional	TC	$170.86	$230.33	$230.33