Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.04 / $213.46 / $532.67	Facility		$69.04	$213.46	$532.67
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.25 / $8.77 / $13.34	Facility	26	$7.25	$8.77	$13.34
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.05 / $37.24 / $318.63	Facility	TC	$22.05	$37.24	$318.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.17 / $37.96 / $108.23	Professional		$19.17	$37.96	$108.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.22 / $9.19 / $41.36	Professional	26	$7.22	$9.19	$41.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.86 / $73.20 / $187.76	Professional	50	$34.86	$73.20	$187.76
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.54 / $14.89 / $29.77	Professional	52	$12.54	$14.89	$29.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.96 / $27.09 / $94.60	Professional	TC	$20.96	$27.09	$94.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.61 / $33.22 / $63.94	Professional		$24.61	$33.22	$63.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.99 / $10.79 / $16.85	Professional	26	$5.99	$10.79	$16.85
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.75 / $58.60 / $58.60	Professional	50	$37.75	$58.60	$58.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $24.18 / $34.68	Professional	TC	$18.62	$24.18	$34.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.22 / $22.22 / $22.22	Professional		$22.22	$22.22	$22.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.22 / $19.11 / $23.74	Professional	26	$13.22	$19.11	$23.74
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.66 / $41.27 / $60.48	Professional	TC	$29.66	$41.27	$60.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.52 / $50.02 / $108.10	Facility		$37.52	$50.02	$108.10
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 $29.46 / $29.46 / $29.46	Facility	TC	$29.46	$29.46	$29.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $48.30 / $81.56	Professional		$28.00	$48.30	$81.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $13.60 / $23.22	Professional	26	$7.93	$13.60	$23.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.57 / $33.51 / $61.88	Professional	TC	$19.57	$33.51	$61.88
Medcost Facility/Professional Facility Modifier Low / Median / High Price $29.77 / $47.00 / $79.08	Facility		$29.77	$47.00	$79.08
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.63 / $15.00 / $25.08	Facility	26	$12.63	$15.00	$25.08
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $26.39 / $30.45 / $69.12	Facility	TC	$26.39	$30.45	$69.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $28.00 / $39.02	Professional		$11.00	$28.00	$39.02
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $12.63 / $15.00 / $29.70	Professional	26	$12.63	$15.00	$29.70
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $58.53 / $70.50 / $182.60	Professional	50	$58.53	$70.50	$182.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.50 / $34.33 / $57.67	Professional		$8.50	$34.33	$57.67
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 $28.27 / $40.90 / $77.39	Professional		$28.27	$40.90	$77.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $11.13 / $23.45	Professional	26	$8.36	$11.13	$23.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.77 / $29.71 / $53.18	Professional	TC	$19.77	$29.71	$53.18
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $72.20 / $359.91 / $359.91	Facility		$72.20	$359.91	$359.91
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $22.09 / $100.00 / $100.00	Facility	26	$22.09	$100.00	$100.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $55.06 / $142.31 / $142.31	Facility	TC	$55.06	$142.31	$142.31
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $219.71 / $219.71 / $286.95	Professional		$219.71	$219.71	$286.95
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $67.70 / $67.70 / $67.70	Professional	26	$67.70	$67.70	$67.70
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $168.70 / $168.70 / $221.85	Professional	TC	$168.70	$168.70	$221.85