Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.00 / $232.96 / $430.95	Facility		$138.00	$232.96	$430.95
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.96 / $8.44 / $13.19	Facility	26	$6.96	$8.44	$13.19
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.48 / $26.05 / $599.29	Facility	TC	$18.48	$26.05	$599.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.04 / $37.43 / $92.13	Professional		$23.04	$37.43	$92.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.97 / $8.77 / $35.65	Professional	26	$6.97	$8.77	$35.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.65 / $121.98 / $178.46	Professional	50	$35.65	$121.98	$178.46
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.41 / $14.02 / $46.72	Professional	52	$13.41	$14.02	$46.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $24.36 / $63.34	Professional	TC	$18.53	$24.36	$63.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.87 / $44.94 / $79.20	Professional		$23.87	$44.94	$79.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $11.86 / $25.11	Professional	26	$5.75	$11.86	$25.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.69 / $29.69 / $29.69	Professional	TC	$29.69	$29.69	$29.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.85 / $19.85 / $19.85	Professional		$19.85	$19.85	$19.85
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.08 / $17.53 / $23.59	Professional	26	$12.08	$17.53	$23.59
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.99 / $39.02 / $57.52	Professional	TC	$27.99	$39.02	$57.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.11 / $46.81 / $103.46	Facility		$35.11	$46.81	$103.46
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 $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.13 / $45.08 / $77.88	Professional		$26.13	$45.08	$77.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.20 / $12.35 / $21.78	Professional	26	$7.20	$12.35	$21.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $31.62 / $57.96	Professional	TC	$18.48	$31.62	$57.96
Medcost Facility/Professional Facility Modifier Low / Median / High Price $28.04 / $44.75 / $74.45	Facility		$28.04	$44.75	$74.45
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $11.27 / $14.00 / $24.78	Facility	26	$11.27	$14.00	$24.78
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $25.38 / $29.92 / $58.16	Facility	TC	$25.38	$29.92	$58.16
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $26.00 / $37.00	Professional		$11.00	$26.00	$37.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $11.27 / $14.00 / $28.52	Professional	26	$11.27	$14.00	$28.52
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $54.98 / $67.50 / $171.95	Professional	50	$54.98	$67.50	$171.95
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $354.10 / $354.10 / $354.10	Facility		$354.10	$354.10	$354.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.50 / $32.33 / $54.41	Professional		$8.50	$32.33	$54.41
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 $26.38 / $36.96 / $72.42	Professional		$26.38	$36.96	$72.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.73 / $10.72 / $20.85	Professional	26	$7.73	$10.72	$20.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.64 / $27.65 / $50.55	Professional	TC	$18.64	$27.65	$50.55
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $67.92 / $359.91 / $359.91	Facility		$67.92	$359.91	$359.91
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 $51.52 / $133.13 / $133.13	Facility	TC	$51.52	$133.13	$133.13
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $206.66 / $206.66 / $270.00	Professional		$206.66	$206.66	$270.00
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 $157.81 / $157.81 / $207.68	Professional	TC	$157.81	$157.81	$207.68