Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.64 / $456.45 / $929.74	Facility		$99.64	$456.45	$929.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.46 / $30.54 / $46.90	Facility	26	$25.46	$30.54	$46.90
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $51.99 / $339.93 / $663.77	Facility	TC	$51.99	$339.93	$663.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.45 / $107.68 / $407.97	Professional		$77.45	$107.68	$407.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $38.61 / $131.21	Professional	26	$25.26	$38.61	$131.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.99 / $77.11 / $153.44	Professional	TC	$51.99	$77.11	$153.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.16 / $75.04 / $163.12	Professional		$63.16	$75.04	$163.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.69 / $39.79 / $58.55	Professional	26	$20.69	$39.79	$58.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.99 / $78.87 / $84.99	Professional	TC	$44.99	$78.87	$84.99
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 $74.75 / $150.00 / $150.01	Professional		$74.75	$150.00	$150.01
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.66 / $62.49 / $85.44	Professional	26	$41.66	$62.49	$85.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.08 / $135.44 / $196.11	Professional	TC	$87.08	$135.44	$196.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.65 / $118.44 / $202.19	Facility		$86.65	$118.44	$202.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.67 / $31.67 / $31.67	Facility	26	$31.67	$31.67	$31.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $66.73 / $66.73 / $66.73	Facility	TC	$66.73	$66.73	$66.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.79 / $128.24 / $233.62	Professional		$88.79	$128.24	$233.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.13 / $42.79 / $75.13	Professional	26	$27.13	$42.79	$75.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.89 / $86.08 / $159.72	Professional	TC	$56.89	$86.08	$159.72
Medcost Facility/Professional Facility Modifier Low / Median / High Price $78.00 / $140.72 / $210.42	Facility		$78.00	$140.72	$210.42
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $42.24 / $58.00 / $79.50	Facility	26	$42.24	$58.00	$79.50
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $67.59 / $103.49 / $172.10	Facility	TC	$67.59	$103.49	$172.10
Medcost Facility/Professional Professional Modifier Low / Median / High Price $37.00 / $112.00 / $316.70	Professional		$37.00	$112.00	$316.70
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $42.24 / $58.00 / $104.14	Professional	26	$42.24	$58.00	$104.14
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $254.51 / $267.07 / $1,049.58	Facility		$254.51	$267.07	$1,049.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.78 / $82.29 / $145.00	Professional		$34.78	$82.29	$145.00
United Facility/Professional Facility Modifier Low / Median / High Price $142.74 / $142.74 / $142.74	Facility		$142.74	$142.74	$142.74
United Facility/Professional Professional Modifier Low / Median / High Price $85.70 / $121.32 / $239.25	Professional		$85.70	$121.32	$239.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.18 / $36.65 / $76.00	Professional	26	$26.18	$36.65	$76.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.63 / $79.09 / $161.00	Professional	TC	$54.63	$79.09	$161.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $188.97 / $539.87 / $539.87	Facility		$188.97	$539.87	$539.87
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $85.90 / $136.18 / $136.18	Facility	26	$85.90	$136.18	$136.18
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $118.69 / $323.95 / $323.95	Facility	TC	$118.69	$323.95	$323.95
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $568.24 / $568.24 / $725.78	Professional		$568.24	$568.24	$725.78
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $227.85 / $227.85 / $227.85	Professional	26	$227.85	$227.85	$227.85
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $390.02 / $390.02 / $501.90	Professional	TC	$390.02	$390.02	$501.90