Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $302.00 / $524.81	Facility		$85.11	$302.00	$524.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $36.31 / $120.23	Facility	26	$28.84	$36.31	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $100.00 / $371.54	Professional		$50.12	$100.00	$371.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $66.07 / $177.83	Professional	26	$28.84	$66.07	$177.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.98 / $173.78 / $676.08	Professional	50	$48.98	$173.78	$676.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $58.88 / $190.55	Professional	TC	$43.65	$58.88	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $79.43 / $158.49	Professional		$64.57	$79.43	$158.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $33.11 / $79.43	Professional	26	$24.55	$33.11	$79.43
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $97.72 / $117.49 / $316.23	Professional	50	$97.72	$117.49	$316.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $51.29 / $69.18	Professional	TC	$36.31	$51.29	$69.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $74.13 / $97.72	Professional	26	$45.71	$74.13	$97.72
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $97.72 / $151.36	Professional	TC	$70.79	$97.72	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $107.15 / $223.87	Facility		$74.13	$107.15	$223.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $37.15 / $52.48	Facility	26	$7.94	$37.15	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $125.89 / $218.78	Professional		$75.86	$125.89	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $48.98 / $87.10	Professional	26	$28.84	$48.98	$87.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $75.86 / $131.83	Professional	TC	$45.71	$75.86	$131.83
Medcost Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $69.18 / $69.18	Professional	26	$69.18	$69.18	$69.18
Medcost Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $95.50 / $194.98	Facility		$74.13	$95.50	$194.98
Medcost Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $549.54 / $549.54	Facility		$501.19	$549.54	$549.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $75.86 / $169.82	Professional		$33.11	$75.86	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $67.61 / $134.90	Facility		$41.69	$67.61	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $102.33 / $186.21	Professional		$79.43	$102.33	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $40.74 / $72.44	Professional	26	$30.90	$40.74	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $61.66 / $112.20	Professional	TC	$47.86	$61.66	$112.20
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Facility		$549.54	$549.54	$549.54
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $204.17 / $204.17 / $204.17	Facility	26	$204.17	$204.17	$204.17
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $707.95	Professional		$549.54	$549.54	$707.95
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $204.17 / $263.03	Professional	26	$204.17	$204.17	$263.03
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $338.84 / $446.68	Professional	TC	$338.84	$338.84	$446.68