Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.51 / $258.33 / $525.54	Facility		$66.51	$258.33	$525.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.96 / $8.77 / $13.34	Facility	26	$6.96	$8.77	$13.34
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.48 / $258.33 / $368.60	Facility	TC	$20.48	$258.33	$368.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.49 / $38.14 / $107.74	Professional		$20.49	$38.14	$107.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.96 / $9.19 / $38.84	Professional	26	$6.96	$9.19	$38.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.11 / $128.00 / $172.89	Professional	50	$43.11	$128.00	$172.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.12 / $23.86 / $68.78	Professional	TC	$18.12	$23.86	$68.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.45 / $59.00 / $76.78	Professional		$23.45	$59.00	$76.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $11.86 / $19.53	Professional	26	$5.75	$11.86	$19.53
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.60 / $25.46 / $28.78	Professional	TC	$17.60	$25.46	$28.78
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 / $23.59	Professional	26	$13.22	$18.79	$23.59
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.62 / $37.86 / $54.99	Professional	TC	$29.62	$37.86	$54.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.15 / $45.53 / $102.75	Facility		$34.15	$45.53	$102.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.85 / $26.85 / $26.85	Facility	TC	$26.85	$26.85	$26.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.63 / $45.19 / $75.28	Professional		$27.63	$45.19	$75.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $13.17 / $22.31	Professional	26	$7.93	$13.17	$22.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $30.72 / $56.29	Professional	TC	$19.14	$30.72	$56.29
Medcost Facility/Professional Facility Modifier Low / Median / High Price $27.46 / $47.38 / $73.09	Facility		$27.46	$47.38	$73.09
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.29 / $15.00 / $23.87	Facility	26	$12.29	$15.00	$23.87
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $26.83 / $40.90 / $62.19	Facility	TC	$26.83	$40.90	$62.19
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $25.00 / $36.65	Professional		$11.00	$25.00	$36.65
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $15.00 / $28.52	Professional	26	$12.29	$15.00	$28.52
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $54.99 / $81.00 / $168.42	Professional	50	$54.99	$81.00	$168.42
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,535.14 / $1,677.06 / $7,854.04	Facility		$1,535.14	$1,677.06	$7,854.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.02 / $30.04 / $52.10	Professional		$8.02	$30.04	$52.10
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $40.07 / $71.15	Professional		$26.92	$40.07	$71.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.06 / $12.50 / $21.58	Professional	26	$8.06	$12.50	$21.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.22 / $26.67 / $47.58	Professional	TC	$18.22	$26.67	$47.58
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $67.23 / $972.00 / $972.00	Facility		$67.23	$972.00	$972.00
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $19.63 / $100.00 / $100.00	Facility	26	$19.63	$100.00	$100.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $50.81 / $131.29 / $131.29	Facility	TC	$50.81	$131.29	$131.29
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $202.34 / $202.34 / $267.14	Professional		$202.34	$202.34	$267.14
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $72.64 / $75.00 / $75.00	Professional	26	$72.64	$75.00	$75.00
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $163.00 / $163.00 / $204.83	Professional	TC	$163.00	$163.00	$204.83