Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.20 / $75.53 / $175.96	Facility		$56.20	$75.53	$175.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.32 / $18.37 / $22.21	Facility	26	$15.32	$18.37	$22.21
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.60 / $37.84 / $53.32	Facility	TC	$30.60	$37.84	$53.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.06 / $173.51 / $810.96	Professional		$65.06	$173.51	$810.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.98 / $56.30 / $363.44	Professional	26	$19.98	$56.30	$363.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.09 / $60.84 / $229.58	Professional	TC	$45.09	$60.84	$229.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.76 / $64.09 / $95.58	Professional		$41.76	$64.09	$95.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.48 / $37.03 / $68.84	Professional	26	$28.48	$37.03	$68.84
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $65.06 / $65.06 / $77.50	Professional	TC	$65.06	$65.06	$77.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.24 / $38.34 / $41.82	Professional	26	$23.24	$38.34	$41.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.90 / $59.26 / $94.24	Professional	TC	$54.90	$59.26	$94.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.97 / $44.47 / $139.54	Professional		$32.97	$44.47	$139.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.16 / $14.46 / $43.59	Professional	26	$11.16	$14.46	$43.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.82 / $30.28 / $93.71	Professional	TC	$21.82	$30.28	$93.71
Medcost Facility/Professional Facility Modifier Low / Median / High Price $67.63 / $95.67 / $117.99	Facility		$67.63	$95.67	$117.99
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $31.92 / $31.92 / $39.36	Facility	26	$31.92	$31.92	$39.36
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $62.51 / $63.75 / $101.26	Facility	TC	$62.51	$63.75	$101.26
Medcost Facility/Professional Professional Modifier Low / Median / High Price $45.90 / $45.90 / $45.90	Professional		$45.90	$45.90	$45.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $57.91 / $177.70	Professional		$17.38	$57.91	$177.70
United Facility/Professional Professional Modifier Low / Median / High Price $40.46 / $63.83 / $150.69	Professional		$40.46	$63.83	$150.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.47 / $21.30 / $46.00	Professional	26	$13.47	$21.30	$46.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.93 / $42.72 / $109.82	Professional	TC	$26.93	$42.72	$109.82
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $516.33 / $516.33 / $516.33	Facility		$516.33	$516.33	$516.33
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $136.56 / $136.56 / $136.56	Facility	26	$136.56	$136.56	$136.56
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $379.76 / $379.76 / $379.76	Facility	TC	$379.76	$379.76	$379.76
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $559.76 / $559.76 / $804.98	Professional		$559.76	$559.76	$804.98
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $173.52 / $173.52 / $219.45	Professional	26	$173.52	$173.52	$219.45
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $386.24 / $386.24 / $585.53	Professional	TC	$386.24	$386.24	$585.53