Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.92 / $57.76 / $94.64	Facility		$25.92	$57.76	$94.64
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.32 / $29.26 / $29.29	Facility	26	$24.32	$29.26	$29.29
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.91 / $27.49 / $40.35	Facility	TC	$17.91	$27.49	$40.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.61 / $123.65 / $876.37	Professional		$55.61	$123.65	$876.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.21 / $56.62 / $535.50	Professional	26	$29.21	$56.62	$535.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.73 / $27.44 / $59.27	Professional	52	$23.73	$27.44	$59.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.92 / $56.74 / $128.32	Professional	TC	$16.92	$56.74	$128.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.29 / $70.73 / $129.02	Professional		$32.29	$70.73	$129.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.03 / $38.25 / $87.10	Professional	26	$17.03	$38.25	$87.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.74 / $33.51 / $71.93	Professional	TC	$32.74	$33.51	$71.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.43 / $130.49 / $171.70	Professional		$59.43	$130.49	$171.70
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.65 / $67.33 / $87.40	Professional	26	$30.65	$67.33	$87.40
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.97 / $39.04 / $82.46	Professional	TC	$31.97	$39.04	$82.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.89 / $66.69 / $156.00	Professional		$33.89	$66.69	$156.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.57 / $32.61 / $65.90	Professional	26	$17.57	$32.61	$65.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.43 / $30.54 / $83.46	Professional	TC	$15.43	$30.54	$83.46
Medcost Facility/Professional Facility Modifier Low / Median / High Price $69.59 / $111.00 / $179.35	Facility		$69.59	$111.00	$179.35
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $52.82 / $75.00 / $120.00	Facility	26	$52.82	$75.00	$120.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $7.00 / $47.81 / $108.21	Facility	TC	$7.00	$47.81	$108.21
Medcost Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $45.00 / $45.00	Professional		$45.00	$45.00	$45.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $21.20 / $39.14 / $114.02	Professional		$21.20	$39.14	$114.02
United Facility/Professional Professional Modifier Low / Median / High Price $40.94 / $67.33 / $145.06	Professional		$40.94	$67.33	$145.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.43 / $37.45 / $66.88	Professional	26	$21.43	$37.45	$66.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $32.61 / $91.62	Professional	TC	$17.89	$32.61	$91.62
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $375.35 / $375.35 / $375.35	Facility		$375.35	$375.35	$375.35
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $179.84 / $179.84 / $179.84	Facility	26	$179.84	$179.84	$179.84
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $216.27 / $216.27 / $216.27	Facility	TC	$216.27	$216.27	$216.27
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $563.97 / $563.97 / $592.20	Professional		$563.97	$563.97	$592.20
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $292.24 / $292.24 / $292.24	Professional	26	$292.24	$292.24	$292.24
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $352.47 / $359.07 / $359.07	Professional	TC	$352.47	$359.07	$359.07