Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.76 / $436.05 / $696.00	Facility		$99.76	$436.05	$696.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.53 / $29.32 / $44.64	Facility	26	$24.53	$29.32	$44.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.49 / $128.90 / $333.07	Professional		$98.49	$128.90	$333.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $28.08 / $103.26	Professional	26	$24.07	$28.08	$103.26
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $46.51 / $49.25 / $72.08	Professional	52	$46.51	$49.25	$72.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.95 / $94.28 / $179.15	Professional	TC	$73.95	$94.28	$179.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.33 / $138.22 / $206.12	Professional		$79.33	$138.22	$206.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.92 / $34.92 / $50.10	Professional	26	$19.92	$34.92	$50.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $59.29 / $112.25 / $118.97	Professional	TC	$59.29	$112.25	$118.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $216.52 / $259.82 / $325.68	Facility		$216.52	$259.82	$325.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.95 / $69.95 / $69.95	Professional		$69.95	$69.95	$69.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.08 / $59.49 / $78.95	Professional	26	$38.08	$59.49	$78.95
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $99.16 / $151.34 / $235.60	Professional	TC	$99.16	$151.34	$235.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.07 / $130.55 / $287.61	Facility		$120.07	$130.55	$287.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.47 / $30.47 / $30.47	Facility	26	$30.47	$30.47	$30.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.17 / $152.93 / $280.18	Professional		$90.17	$152.93	$280.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.14 / $40.71 / $70.81	Professional	26	$25.14	$40.71	$70.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.91 / $113.80 / $212.64	Professional	TC	$62.91	$113.80	$212.64
Medcost Facility/Professional Facility Modifier Low / Median / High Price $98.49 / $136.44 / $235.27	Facility		$98.49	$136.44	$235.27
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $39.65 / $46.00 / $74.15	Facility	26	$39.65	$46.00	$74.15
Medcost Facility/Professional Professional Modifier Low / Median / High Price $36.00 / $120.00 / $402.70	Professional		$36.00	$120.00	$402.70
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $39.65 / $46.00 / $100.32	Professional	26	$39.65	$46.00	$100.32
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $254.51 / $546.51 / $1,199.23	Facility		$254.51	$546.51	$1,199.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.48 / $109.86 / $181.32	Professional		$27.48	$109.86	$181.32
United Facility/Professional Facility Modifier Low / Median / High Price $31.63 / $116.31 / $153.22	Facility		$31.63	$116.31	$153.22
United Facility/Professional Professional Modifier Low / Median / High Price $96.30 / $137.63 / $301.39	Professional		$96.30	$137.63	$301.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.07 / $34.97 / $72.91	Professional	26	$25.07	$34.97	$72.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.43 / $99.40 / $226.04	Professional	TC	$68.43	$99.40	$226.04
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $232.99 / $584.77 / $584.77	Facility		$232.99	$584.77	$584.77
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $83.44 / $131.34 / $131.34	Facility	26	$83.44	$131.34	$131.34
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $726.73 / $726.73 / $920.03	Professional		$726.73	$726.73	$920.03
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $255.92 / $255.92 / $255.92	Professional	26	$255.92	$255.92	$255.92
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $554.94 / $554.94 / $703.88	Professional	TC	$554.94	$554.94	$703.88