Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.86 / $605.24 / $931.95	Facility		$99.86	$605.24	$931.95
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.63 / $41.94 / $64.22	Facility	26	$34.63	$41.94	$64.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.67 / $144.03 / $516.34	Professional		$103.67	$144.03	$516.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.28 / $43.72 / $160.57	Professional	26	$33.28	$43.72	$160.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.04 / $91.94 / $187.52	Professional	TC	$69.04	$91.94	$187.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.06 / $113.47 / $285.47	Professional		$84.06	$113.47	$285.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.41 / $38.61 / $71.50	Professional	26	$28.41	$38.61	$71.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $55.46 / $97.04 / $111.27	Professional	TC	$55.46	$97.04	$111.27
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 $101.95 / $101.95 / $101.95	Professional		$101.95	$101.95	$101.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.41 / $86.31 / $116.25	Professional	26	$57.41	$86.31	$116.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $115.57 / $177.82 / $244.84	Professional	TC	$115.57	$177.82	$244.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.07 / $130.55 / $268.51	Facility		$115.07	$130.55	$268.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.62 / $43.62 / $43.62	Facility	26	$43.62	$43.62	$43.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.48 / $171.64 / $313.36	Professional		$119.48	$171.64	$313.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.92 / $59.27 / $102.89	Professional	26	$36.92	$59.27	$102.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.90 / $115.07 / $207.81	Professional	TC	$78.90	$115.07	$207.81
Medcost Facility/Professional Facility Modifier Low / Median / High Price $104.34 / $185.69 / $279.17	Facility		$104.34	$185.69	$279.17
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $58.17 / $79.00 / $107.42	Facility	26	$58.17	$79.00	$107.42
Medcost Facility/Professional Professional Modifier Low / Median / High Price $51.00 / $149.00 / $423.90	Professional		$51.00	$149.00	$423.90
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $58.17 / $58.17 / $79.00	Professional	26	$58.17	$58.17	$79.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $282.33 / $282.33 / $282.33	Professional	TC	$282.33	$282.33	$282.33
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $254.51 / $278.04 / $1,632.31	Facility		$254.51	$278.04	$1,632.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $46.46 / $109.40 / $192.58	Professional		$46.46	$109.40	$192.58
United Facility/Professional Professional Modifier Low / Median / High Price $110.16 / $152.24 / $317.38	Professional		$110.16	$152.24	$317.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.82 / $49.88 / $105.29	Professional	26	$35.82	$49.88	$105.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.41 / $101.29 / $203.78	Professional	TC	$76.41	$101.29	$203.78
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $252.78 / $611.17 / $611.17	Facility		$252.78	$611.17	$611.17
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $187.10 / $187.10	Facility	26	$100.00	$187.10	$187.10
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $760.68 / $760.68 / $966.00	Professional		$760.68	$760.68	$966.00
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $303.79 / $303.79 / $307.35	Professional	26	$303.79	$303.79	$307.35
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $518.02 / $518.02 / $658.65	Professional	TC	$518.02	$518.02	$658.65