Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.59 / $60.56 / $95.30	Facility		$19.59	$60.56	$95.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.07 / $20.85 / $20.87	Facility	26	$17.07	$20.85	$20.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.56 / $43.49 / $66.31	Facility	TC	$32.56	$43.49	$66.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.91 / $108.22 / $307.64	Professional		$76.91	$108.22	$307.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.57 / $26.08 / $121.35	Professional	26	$20.57	$26.08	$121.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.18 / $80.48 / $147.03	Professional	TC	$57.18	$80.48	$147.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.72 / $105.32 / $200.92	Professional		$62.72	$105.32	$200.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.14 / $34.40 / $57.88	Professional	26	$12.14	$34.40	$57.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $80.84 / $80.84 / $154.63	Professional	TC	$80.84	$80.84	$154.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.92 / $122.20 / $131.30	Professional		$82.92	$122.20	$131.30
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.84 / $42.20 / $51.20	Professional	26	$21.84	$42.20	$51.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.23 / $69.40 / $105.54	Professional	TC	$50.23	$69.40	$105.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.24 / $63.47 / $170.03	Professional		$37.24	$63.47	$170.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.49 / $14.51 / $47.54	Professional	26	$12.49	$14.51	$47.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.61 / $40.93 / $125.51	Professional	TC	$22.61	$40.93	$125.51
Medcost Facility/Professional Facility Modifier Low / Median / High Price $66.11 / $120.12 / $162.46	Facility		$66.11	$120.12	$162.46
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $26.00 / $30.45 / $54.00	Facility	26	$26.00	$30.45	$54.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $69.40 / $103.25 / $168.57	Facility	TC	$69.40	$103.25	$168.57
Medcost Facility/Professional Professional Modifier Low / Median / High Price $7.56 / $7.56 / $7.56	Professional		$7.56	$7.56	$7.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.90 / $67.02 / $204.72	Professional		$15.90	$67.02	$204.72
United Facility/Professional Professional Modifier Low / Median / High Price $52.77 / $89.09 / $160.79	Professional		$52.77	$89.09	$160.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.28 / $25.46 / $44.51	Professional	26	$15.28	$25.46	$44.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.63 / $62.16 / $127.04	Professional	TC	$37.63	$62.16	$127.04
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $599.64 / $599.64 / $599.64	Facility		$599.64	$599.64	$599.64
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $127.87 / $127.87 / $127.87	Facility	26	$127.87	$127.87	$127.87
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $471.77 / $471.77 / $471.77	Facility	TC	$471.77	$471.77	$471.77
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $715.47 / $715.47 / $937.95	Professional		$715.47	$715.47	$937.95
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $162.69 / $162.69 / $205.80	Professional	26	$162.69	$162.69	$205.80
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $552.78 / $552.78 / $732.15	Professional	TC	$552.78	$552.78	$732.15