Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $0.57 / $77.75 / $347.18	Facility		$0.57	$77.75	$347.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.19 / $29.57 / $41.93	Facility	26	$28.19	$29.57	$41.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.49 / $77.33 / $150.71	Professional		$39.49	$77.33	$150.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.10 / $31.46 / $66.29	Professional	26	$28.10	$31.46	$66.29
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.36 / $277.39 / $334.86	Professional	50	$43.36	$277.39	$334.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.42 / $24.08 / $72.81	Professional	52	$22.42	$24.08	$72.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.41 / $32.90 / $81.69	Professional	TC	$16.41	$32.90	$81.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.35 / $44.35 / $150.71	Professional		$44.35	$44.35	$150.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.51 / $28.51 / $53.74	Professional	26	$28.51	$28.51	$53.74
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $226.07 / $226.07 / $226.07	Professional	50	$226.07	$226.07	$226.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $96.99 / $96.99 / $96.99	Professional	TC	$96.99	$96.99	$96.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.70 / $72.70 / $72.70	Professional		$72.70	$72.70	$72.70
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.36 / $56.11 / $85.45	Professional	26	$34.36	$56.11	$85.45
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.85 / $102.07 / $144.96	Professional	TC	$55.85	$102.07	$144.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.57 / $52.57 / $52.57	Facility		$52.57	$52.57	$52.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $33.84	Facility	26	$33.84	$33.84	$33.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.24 / $103.55 / $194.37	Professional		$55.24	$103.55	$194.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.84 / $43.93 / $76.62	Professional	26	$27.84	$43.93	$76.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.24 / $60.96 / $116.61	Professional	TC	$23.24	$60.96	$116.61
Medcost Facility/Professional Facility Modifier Low / Median / High Price $48.16 / $86.00 / $153.79	Facility		$48.16	$86.00	$153.79
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $29.00 / $30.26 / $65.68	Facility	26	$29.00	$30.26	$65.68
Medcost Facility/Professional Professional Modifier Low / Median / High Price $39.00 / $78.23 / $177.23	Professional		$39.00	$78.23	$177.23
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $29.00 / $30.26 / $108.82	Professional	26	$29.00	$30.26	$108.82
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $117.36 / $129.00 / $265.83	Professional	50	$117.36	$129.00	$265.83
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $353.87 / $353.87 / $353.87	Facility		$353.87	$353.87	$353.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.23 / $47.62 / $129.60	Professional		$19.23	$47.62	$129.60
United Facility/Professional Professional Modifier Low / Median / High Price $43.44 / $73.02 / $166.62	Professional		$43.44	$73.02	$166.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.39 / $32.86 / $73.08	Professional	26	$15.39	$32.86	$73.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.53 / $39.90 / $102.16	Professional	TC	$25.53	$39.90	$102.16
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $122.00 / $267.77 / $267.77	Facility		$122.00	$267.77	$267.77
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $68.52 / $149.91 / $149.91	Facility	26	$68.52	$149.91	$149.91
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $472.92 / $472.92 / $472.92	Professional		$472.92	$472.92	$472.92
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $188.73 / $188.73 / $239.70	Professional	26	$188.73	$188.73	$239.70
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $323.00 / $323.00 / $323.00	Professional	TC	$323.00	$323.00	$323.00