Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.04 / $242.55 / $532.62	Facility		$69.04	$242.55	$532.62
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.28 / $8.80 / $13.39	Facility	26	$7.28	$8.80	$13.39
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.80 / $273.74 / $630.40	Facility	TC	$22.80	$273.74	$630.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.22 / $44.72 / $122.72	Professional		$22.22	$44.72	$122.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.28 / $10.50 / $41.00	Professional	26	$7.28	$10.50	$41.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.46 / $90.33 / $185.25	Professional	50	$15.46	$90.33	$185.25
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.93 / $15.04 / $45.15	Professional	52	$13.93	$15.04	$45.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.20 / $29.96 / $73.78	Professional	TC	$22.20	$29.96	$73.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.35 / $42.56 / $83.26	Professional		$25.35	$42.56	$83.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.01 / $10.66 / $16.89	Professional	26	$6.01	$10.66	$16.89
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.77 / $71.87 / $71.87	Professional	50	$37.77	$71.87	$71.87
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $27.17 / $39.60	Professional	TC	$18.62	$27.17	$39.60
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 / $18.62 / $23.65	Professional	26	$13.22	$18.62	$23.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.73 / $43.59 / $58.69	Professional	TC	$30.73	$43.59	$58.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.00 / $50.67 / $108.10	Facility		$38.00	$50.67	$108.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.25 / $9.25 / $9.25	Facility	26	$9.25	$9.25	$9.25
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 $27.38 / $46.92 / $81.64	Professional		$27.38	$46.92	$81.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $13.26 / $23.01	Professional	26	$7.93	$13.26	$23.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.30 / $35.29 / $61.39	Professional	TC	$20.30	$35.29	$61.39
Medcost Facility/Professional Facility Modifier Low / Median / High Price $30.08 / $50.09 / $79.13	Facility		$30.08	$50.09	$79.13
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.29 / $17.00 / $24.84	Facility	26	$12.29	$17.00	$24.84
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $29.42 / $44.88 / $67.14	Facility	TC	$29.42	$44.88	$67.14
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $26.00 / $41.67	Professional		$11.00	$26.00	$41.67
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $17.00 / $29.77	Professional	26	$12.29	$17.00	$29.77
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $62.51 / $81.00 / $184.53	Professional	50	$62.51	$81.00	$184.53
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $211.85 / $231.82 / $1,141.61	Facility		$211.85	$231.82	$1,141.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.50 / $33.89 / $55.89	Professional		$8.50	$33.89	$55.89
United Facility/Professional Facility Modifier Low / Median / High Price $65.26 / $65.26 / $194.81	Facility		$65.26	$65.26	$194.81
United Facility/Professional Professional Modifier Low / Median / High Price $29.01 / $43.23 / $82.13	Professional		$29.01	$43.23	$82.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $11.16 / $20.93	Professional	26	$8.22	$11.16	$20.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.51 / $30.84 / $57.54	Professional	TC	$20.51	$30.84	$57.54
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $72.23 / $359.91 / $359.91	Facility		$72.23	$359.91	$359.91
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $27.00 / $100.00 / $100.00	Facility	26	$27.00	$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 $221.82 / $221.82 / $286.73	Professional		$221.82	$221.82	$286.73
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $71.00 / $71.00 / $71.00	Professional	26	$71.00	$71.00	$71.00
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $170.86 / $170.86 / $221.85	Professional	TC	$170.86	$170.86	$221.85