Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.29 / $231.88 / $553.95	Facility		$43.29	$231.88	$553.95
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.22 / $61.50 / $64.09	Facility	26	$53.22	$61.50	$64.09
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $63.29 / $109.39 / $160.19	Facility	TC	$63.29	$109.39	$160.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.12 / $253.35 / $570.24	Professional		$186.12	$253.35	$570.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.15 / $80.20 / $689.64	Professional	26	$62.15	$80.20	$689.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.21 / $154.54 / $359.94	Professional	TC	$104.21	$154.54	$359.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.91 / $277.60 / $326.01	Professional		$123.91	$277.60	$326.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.27 / $83.39 / $183.01	Professional	26	$37.27	$83.39	$183.01
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $195.34 / $195.34 / $195.34	Professional	TC	$195.34	$195.34	$195.34
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.09 / $137.84 / $173.65	Professional	26	$67.09	$137.84	$173.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.42 / $167.64 / $283.13	Professional	TC	$93.42	$167.64	$283.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.33 / $178.65 / $470.39	Professional		$89.33	$178.65	$470.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.36 / $65.50 / $140.55	Professional	26	$38.36	$65.50	$140.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.51 / $96.59 / $316.81	Professional	TC	$50.51	$96.59	$316.81
Medcost Facility/Professional Facility Modifier Low / Median / High Price $160.00 / $225.60 / $396.46	Facility		$160.00	$225.60	$396.46
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $112.73 / $115.00 / $192.20	Facility	26	$112.73	$115.00	$192.20
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $167.64 / $250.00 / $435.24	Facility	TC	$167.64	$250.00	$435.24
Medcost Facility/Professional Professional Modifier Low / Median / High Price $77.40 / $77.40 / $77.40	Professional		$77.40	$77.40	$77.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.23 / $170.34 / $520.77	Professional		$50.23	$170.34	$520.77
United Facility/Professional Professional Modifier Low / Median / High Price $132.58 / $254.10 / $436.00	Professional		$132.58	$254.10	$436.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.33 / $81.97 / $135.94	Professional	26	$47.33	$81.97	$135.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.47 / $171.44 / $311.81	Professional	TC	$86.47	$171.44	$311.81
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $1,535.15 / $1,535.15 / $1,535.15	Facility		$1,535.15	$1,535.15	$1,535.15
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $395.34 / $395.34 / $395.34	Facility	26	$395.34	$395.34	$395.34
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $1,139.81 / $1,139.81 / $1,139.81	Facility	TC	$1,139.81	$1,139.81	$1,139.81
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,813.36 / $1,813.36 / $2,402.03	Professional		$1,813.36	$1,813.36	$2,402.03
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $509.36 / $509.36 / $635.03	Professional	26	$509.36	$509.36	$635.03
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,303.99 / $1,303.99 / $1,767.00	Professional	TC	$1,303.99	$1,303.99	$1,767.00