Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $80.02 / $203.00	Facility		$10.72	$80.02	$203.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.18 / $45.96 / $48.67	Facility	26	$40.18	$45.96	$48.67
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $15.50 / $19.61 / $31.36	Facility	TC	$15.50	$19.61	$31.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.45 / $88.26 / $171.60	Professional		$69.45	$88.26	$171.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.30 / $60.81 / $620.00	Professional	26	$48.30	$60.81	$620.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.00 / $32.97 / $70.43	Professional	TC	$28.00	$32.97	$70.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.65 / $100.65 / $100.65	Professional		$100.65	$100.65	$100.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.30 / $62.78 / $138.13	Professional	26	$28.30	$62.78	$138.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.00 / $154.00 / $154.00	Professional		$154.00	$154.00	$154.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.93 / $96.07 / $124.38	Professional	26	$50.93	$96.07	$124.38
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.75 / $37.67 / $57.19	Professional	TC	$24.75	$37.67	$57.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.15 / $89.02 / $160.44	Professional		$42.15	$89.02	$160.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.03 / $54.60 / $105.47	Professional	26	$29.03	$54.60	$105.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.01 / $20.55 / $61.59	Professional	TC	$12.01	$20.55	$61.59
Medcost Facility/Professional Facility Modifier Low / Median / High Price $86.22 / $127.00 / $187.85	Facility		$86.22	$127.00	$187.85
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $85.32 / $98.00 / $140.00	Facility	26	$85.32	$98.00	$140.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $38.43 / $49.19 / $90.32	Facility	TC	$38.43	$49.19	$90.32
Medcost Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $90.00 / $90.00	Professional		$90.00	$90.00	$90.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.84 / $60.12 / $188.72	Professional		$23.84	$60.12	$188.72
United Facility/Professional Professional Modifier Low / Median / High Price $52.60 / $86.52 / $149.04	Professional		$52.60	$86.52	$149.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.61 / $59.36 / $101.86	Professional	26	$35.61	$59.36	$101.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.76 / $29.76 / $49.97	Professional	TC	$16.76	$29.76	$49.97
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $523.92 / $523.92 / $523.92	Facility		$523.92	$523.92	$523.92
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $300.87 / $300.87 / $300.87	Facility	26	$300.87	$300.87	$300.87
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $223.06 / $223.06 / $223.06	Facility	TC	$223.06	$223.06	$223.06
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $643.49 / $643.49 / $828.68	Professional		$643.49	$643.49	$828.68
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $383.71 / $383.71 / $482.40	Professional	26	$383.71	$383.71	$482.40
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $350.03 / $350.03 / $350.03	Professional	TC	$350.03	$350.03	$350.03