Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.30 / $67.00 / $193.14	Facility		$53.30	$67.00	$193.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.94 / $21.69 / $45.35	Facility	26	$17.94	$21.69	$45.35
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.99 / $31.61 / $37.00	Facility	TC	$22.99	$31.61	$37.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.15 / $62.48 / $99.51	Professional		$51.15	$62.48	$99.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.12 / $26.66 / $56.91	Professional	26	$6.12	$26.66	$56.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.69 / $36.89 / $63.84	Professional	TC	$8.69	$36.89	$63.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.62 / $65.81 / $66.43	Professional		$29.62	$65.81	$66.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.61 / $28.15 / $49.14	Professional	26	$12.61	$28.15	$49.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.65 / $37.65 / $38.54	Professional	TC	$37.65	$37.65	$38.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.70 / $83.69 / $113.71	Professional	26	$22.70	$83.69	$113.71
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.08 / $40.14 / $92.81	Professional	TC	$33.08	$40.14	$92.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.97 / $57.37 / $168.87	Professional		$31.97	$57.37	$168.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.52 / $30.11 / $82.12	Professional	26	$13.52	$30.11	$82.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.38 / $25.83 / $76.59	Professional	TC	$18.38	$25.83	$76.59
Medcost Facility/Professional Facility Modifier Low / Median / High Price $61.38 / $140.86 / $183.57	Facility		$61.38	$140.86	$183.57
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $31.63 / $73.73 / $152.00	Facility	26	$31.63	$73.73	$152.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $42.41 / $78.47 / $78.47	Facility	TC	$42.41	$78.47	$78.47
Medcost Facility/Professional Professional Modifier Low / Median / High Price $123.50 / $123.50 / $123.50	Professional		$123.50	$123.50	$123.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $16.96 / $40.29 / $114.85	Professional		$16.96	$40.29	$114.85
United Facility/Professional Professional Modifier Low / Median / High Price $38.97 / $61.71 / $151.56	Professional		$38.97	$61.71	$151.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.92 / $28.20 / $76.09	Professional	26	$16.92	$28.20	$76.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.12 / $33.70 / $79.40	Professional	TC	$22.12	$33.70	$79.40
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $379.47 / $379.47 / $379.47	Facility		$379.47	$379.47	$379.47
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $234.18 / $234.18 / $234.18	Facility	26	$234.18	$234.18	$234.18
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $224.87 / $224.87 / $224.87	Facility	TC	$224.87	$224.87	$224.87
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $645.55 / $645.55 / $645.55	Professional		$645.55	$645.55	$645.55
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $513.00 / $513.00 / $513.00	Professional	26	$513.00	$513.00	$513.00
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $321.52 / $321.52 / $349.13	Professional	TC	$321.52	$321.52	$349.13