Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.93 / $503.15 / $928.05	Facility		$58.93	$503.15	$928.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.16 / $14.65 / $22.88	Facility	26	$12.16	$14.65	$22.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.91 / $34.42 / $81.09	Professional		$30.91	$34.42	$81.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.66 / $14.04 / $52.87	Professional	26	$11.66	$14.04	$52.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $22.26 / $43.20	Professional	TC	$17.89	$22.26	$43.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.77 / $31.66 / $52.37	Professional		$27.77	$31.66	$52.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.81 / $20.72 / $28.19	Professional	26	$10.81	$20.72	$28.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.58 / $39.58 / $39.58	Professional		$39.58	$39.58	$39.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.80 / $32.11 / $41.74	Professional	26	$19.80	$32.11	$41.74
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.52 / $43.04 / $55.61	Professional	TC	$25.52	$43.04	$55.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.87 / $42.87 / $66.59	Facility		$42.87	$42.87	$66.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.88 / $15.88 / $15.88	Facility	26	$15.88	$15.88	$15.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.71 / $51.04 / $88.67	Professional		$32.71	$51.04	$88.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.31 / $21.82 / $37.38	Professional	26	$14.31	$21.82	$37.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.55 / $28.96 / $52.49	Professional	TC	$17.55	$28.96	$52.49
Medcost Facility/Professional Facility Modifier Low / Median / High Price $34.42 / $50.00 / $71.09	Facility		$34.42	$50.00	$71.09
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $21.93 / $24.55 / $53.14	Facility	26	$21.93	$24.55	$53.14
Medcost Facility/Professional Professional Modifier Low / Median / High Price $18.00 / $39.00 / $140.76	Professional		$18.00	$39.00	$140.76
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $21.98 / $21.98 / $21.98	Professional	26	$21.98	$21.98	$21.98
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $28.41 / $91.01 / $91.01	Professional	TC	$28.41	$91.01	$91.01
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $8,397.87 / $17,606.08 / $26,797.32	Facility		$8,397.87	$17,606.08	$26,797.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.35 / $38.61 / $66.84	Professional		$19.35	$38.61	$66.84
United Facility/Professional Professional Modifier Low / Median / High Price $30.44 / $42.63 / $90.51	Professional		$30.44	$42.63	$90.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.73 / $18.13 / $38.47	Professional	26	$13.73	$18.13	$38.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.75 / $24.29 / $51.45	Professional	TC	$16.75	$24.29	$51.45
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $539.87 / $539.87	Facility		$80.00	$539.87	$539.87
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $31.93 / $100.00 / $100.00	Facility	26	$31.93	$100.00	$100.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $287.00 / $287.00 / $321.52	Professional		$287.00	$287.00	$321.52
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $108.15 / $108.15 / $204.67	Professional	26	$108.15	$108.15	$204.67
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $230.00 / $230.00 / $230.00	Professional	TC	$230.00	$230.00	$230.00