Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.24 / $201.61 / $390.04	Facility		$63.24	$201.61	$390.04
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.87 / $8.38 / $14.45	Facility	26	$7.87	$8.38	$14.45
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.46 / $77.06 / $318.63	Facility	TC	$18.46	$77.06	$318.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.71 / $38.75 / $106.13	Professional		$24.71	$38.75	$106.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.88 / $9.55 / $38.18	Professional	26	$7.88	$9.55	$38.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.45 / $20.50 / $50.65	Professional	TC	$17.45	$20.50	$50.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.51 / $29.40 / $72.90	Professional		$18.51	$29.40	$72.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.51 / $12.45 / $22.08	Professional	26	$6.51	$12.45	$22.08
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.27 / $22.90 / $32.60	Professional	TC	$15.27	$22.90	$32.60
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.61 / $20.34 / $25.75	Professional	26	$14.61	$20.34	$25.75
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.90 / $37.59 / $49.18	Professional	TC	$27.90	$37.59	$49.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.77 / $41.03 / $102.75	Facility		$30.77	$41.03	$102.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $24.24 / $24.24 / $24.24	Facility	TC	$24.24	$24.24	$24.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.69 / $44.10 / $74.86	Professional		$26.69	$44.10	$74.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $14.26 / $24.91	Professional	26	$9.41	$14.26	$24.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.45 / $29.96 / $50.10	Professional	TC	$17.45	$29.96	$50.10
Medcost Facility/Professional Facility Modifier Low / Median / High Price $26.35 / $38.88 / $62.95	Facility		$26.35	$38.88	$62.95
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $10.17 / $15.48 / $26.90	Facility	26	$10.17	$15.48	$26.90
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $24.91 / $25.52 / $41.76	Facility	TC	$24.91	$25.52	$41.76
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $38.88 / $107.75	Professional		$11.00	$38.88	$107.75
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $32.24 / $32.24 / $32.24	Professional	26	$32.24	$32.24	$32.24
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $25.52 / $25.52 / $25.52	Professional	TC	$25.52	$25.52	$25.52
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,015.78 / $1,067.56 / $3,472.95	Facility		$1,015.78	$1,067.56	$3,472.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.05 / $27.76 / $49.55	Professional		$9.05	$27.76	$49.55
United Facility/Professional Professional Modifier Low / Median / High Price $26.01 / $39.04 / $68.19	Professional		$26.01	$39.04	$68.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.72 / $25.08	Professional	26	$8.91	$12.72	$25.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.25 / $24.05 / $44.43	Professional	TC	$17.25	$24.05	$44.43
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $60.46 / $359.91 / $359.91	Facility		$60.46	$359.91	$359.91
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $20.47 / $70.00 / $70.00	Facility	26	$20.47	$70.00	$70.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $45.10 / $116.61 / $116.61	Facility	TC	$45.10	$116.61	$116.61
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $193.62 / $252.53 / $252.53	Professional		$193.62	$252.53	$252.53
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $55.28 / $70.34 / $70.34	Professional	26	$55.28	$70.34	$70.34
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $138.27 / $182.25 / $182.25	Professional	TC	$138.27	$182.25	$182.25