Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.55 / $234.43 / $407.88	Facility		$57.55	$234.43	$407.88
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.67 / $8.07 / $12.29	Facility	26	$6.67	$8.07	$12.29
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.75 / $25.36 / $398.32	Facility	TC	$17.75	$25.36	$398.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.75 / $37.38 / $97.16	Professional		$21.75	$37.38	$97.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.67 / $8.07 / $37.00	Professional	26	$6.67	$8.07	$37.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $51.24 / $109.60 / $162.15	Professional	50	$51.24	$109.60	$162.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.76 / $12.29 / $39.03	Professional	52	$11.76	$12.29	$39.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $21.09 / $56.57	Professional	TC	$17.89	$21.09	$56.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.46 / $28.37 / $68.77	Professional		$17.46	$28.37	$68.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.51 / $9.77 / $20.21	Professional	26	$5.51	$9.77	$20.21
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.03 / $15.03 / $25.57	Professional	TC	$15.03	$15.03	$25.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.98 / $43.98 / $43.98	Professional		$43.98	$43.98	$43.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $16.57 / $21.66	Professional	26	$12.02	$16.57	$21.66
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.98 / $37.58 / $51.18	Professional	TC	$27.98	$37.58	$51.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.81 / $39.75 / $102.75	Facility		$29.81	$39.75	$102.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $8.51 / $8.51	Facility	26	$8.51	$8.51	$8.51
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.86 / $23.86 / $23.86	Facility	TC	$23.86	$23.86	$23.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.47 / $40.68 / $70.64	Professional		$23.47	$40.68	$70.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.20 / $12.19 / $21.11	Professional	26	$7.20	$12.19	$21.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.87 / $29.81 / $50.02	Professional	TC	$17.87	$29.81	$50.02
Medcost Facility/Professional Facility Modifier Low / Median / High Price $24.57 / $43.56 / $68.01	Facility		$24.57	$43.56	$68.01
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $11.27 / $14.00 / $22.80	Facility	26	$11.27	$14.00	$22.80
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $23.48 / $37.15 / $55.25	Facility	TC	$23.48	$37.15	$55.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $22.00 / $35.64	Professional		$10.00	$22.00	$35.64
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $11.27 / $14.00 / $27.34	Professional	26	$11.27	$14.00	$27.34
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $53.46 / $67.50 / $150.69	Professional	50	$53.46	$67.50	$150.69
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $211.85 / $231.46 / $2,230.26	Facility		$211.85	$231.46	$2,230.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.16 / $27.59 / $47.11	Professional		$8.16	$27.59	$47.11
United Facility/Professional Professional Modifier Low / Median / High Price $25.72 / $34.22 / $67.84	Professional		$25.72	$34.22	$67.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.54 / $11.12 / $20.92	Professional	26	$7.54	$11.12	$20.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.04 / $23.68 / $47.95	Professional	TC	$18.04	$23.68	$47.95
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $60.10 / $359.91 / $359.91	Facility		$60.10	$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 $44.39 / $114.81 / $114.81	Facility	TC	$44.39	$114.81	$114.81
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $180.63 / $180.63 / $238.88	Professional		$180.63	$180.63	$238.88
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 $154.00 / $154.00 / $179.40	Professional	TC	$154.00	$154.00	$179.40