Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.15 / $239.64 / $584.50	Facility		$84.15	$239.64	$584.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.16 / $9.88 / $15.04	Facility	26	$8.16	$9.88	$15.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.42 / $292.29 / $609.84	Facility	TC	$27.42	$292.29	$609.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.92 / $46.00 / $162.94	Professional		$25.92	$46.00	$162.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.16 / $12.90 / $46.64	Professional	26	$8.16	$12.90	$46.64
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.18 / $75.44 / $221.51	Professional	50	$38.18	$75.44	$221.51
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.78 / $17.80 / $30.41	Professional	52	$14.78	$17.80	$30.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.32 / $32.61 / $125.54	Professional	TC	$25.32	$32.61	$125.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.23 / $56.63 / $98.53	Professional		$30.23	$56.63	$98.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.75 / $11.76 / $18.97	Professional	26	$6.75	$11.76	$18.97
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $45.13 / $84.95 / $97.22	Professional	50	$45.13	$84.95	$97.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.70 / $30.60 / $48.36	Professional	TC	$22.70	$30.60	$48.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.17 / $23.17 / $23.17	Professional		$23.17	$23.17	$23.17
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.93 / $20.03 / $26.58	Professional	26	$13.93	$20.03	$26.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.22 / $50.07 / $71.47	Professional	TC	$34.22	$50.07	$71.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $60.94 / $108.10	Facility		$45.71	$60.94	$108.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.79 / $35.79 / $35.79	Facility	TC	$35.79	$35.79	$35.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.13 / $56.16 / $96.61	Professional		$33.13	$56.16	$96.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.31 / $14.57 / $25.64	Professional	26	$8.31	$14.57	$25.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.05 / $41.07 / $74.20	Professional	TC	$23.05	$41.07	$74.20
Medcost Facility/Professional Facility Modifier Low / Median / High Price $35.60 / $56.64 / $91.80	Facility		$35.60	$56.64	$91.80
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $13.67 / $16.00 / $27.82	Facility	26	$13.67	$16.00	$27.82
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $34.65 / $51.07 / $82.01	Facility	TC	$34.65	$51.07	$82.01
Medcost Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $33.00 / $46.55	Professional		$12.00	$33.00	$46.55
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $13.67 / $16.00 / $33.40	Professional	26	$13.67	$16.00	$33.40
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $69.83 / $88.50 / $218.32	Professional	50	$69.83	$88.50	$218.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.84 / $40.92 / $70.47	Professional		$9.84	$40.92	$70.47
United Facility/Professional Professional Modifier Low / Median / High Price $31.77 / $47.23 / $92.12	Professional		$31.77	$47.23	$92.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $13.46 / $25.99	Professional	26	$9.02	$13.46	$25.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.97 / $37.54 / $68.03	Professional	TC	$23.97	$37.54	$68.03
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $86.50 / $359.91 / $359.91	Facility		$86.50	$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 $67.18 / $173.52 / $173.52	Facility	TC	$67.18	$173.52	$173.52
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $263.06 / $263.06 / $343.05	Professional		$263.06	$263.06	$343.05
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $79.26 / $79.26 / $79.26	Professional	26	$79.26	$79.26	$79.26
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $205.55 / $205.55 / $269.93	Professional	TC	$205.55	$205.55	$269.93