Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $477.71 / $1,268.25 / $2,910.00	Facility		$477.71	$1,268.25	$2,910.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.40 / $69.22 / $194.10	Facility	26	$67.40	$69.22	$194.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.58 / $239.34 / $731.07	Professional		$140.58	$239.34	$731.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $71.51 / $242.00	Professional	26	$63.10	$71.51	$242.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $113.27 / $163.59 / $359.92	Professional	TC	$113.27	$163.59	$359.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.54 / $291.93 / $536.76	Professional		$141.54	$291.93	$536.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.11 / $112.04 / $153.53	Professional	26	$54.11	$112.04	$153.53
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $141.88 / $173.01 / $220.54	Professional	TC	$141.88	$173.01	$220.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.21 / $151.21 / $173.72	Professional		$151.21	$151.21	$173.72
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.29 / $140.01 / $216.04	Professional	26	$97.29	$140.01	$216.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $222.11 / $298.37 / $469.55	Professional	TC	$222.11	$298.37	$469.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $219.59 / $219.59 / $219.59	Facility		$219.59	$219.59	$219.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.01 / $78.01 / $78.01	Facility	26	$78.01	$78.01	$78.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.57 / $349.67 / $568.91	Professional		$230.57	$349.67	$568.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.05 / $106.27 / $191.09	Professional	26	$76.05	$106.27	$191.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $148.79 / $241.33 / $398.80	Professional	TC	$148.79	$241.33	$398.80
Medcost Facility/Professional Facility Modifier Low / Median / High Price $193.49 / $288.88 / $441.67	Facility		$193.49	$288.88	$441.67
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $73.56 / $83.39 / $185.82	Facility	26	$73.56	$83.39	$185.82
Medcost Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $244.90 / $712.04	Professional		$81.00	$244.90	$712.04
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $171.35 / $213.23 / $459.45	Professional	TC	$171.35	$213.23	$459.45
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,330.19 / $1,395.88 / $2,862.66	Facility		$1,330.19	$1,395.88	$2,862.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $98.47 / $197.65 / $335.61	Professional		$98.47	$197.65	$335.61
United Facility/Professional Professional Modifier Low / Median / High Price $200.03 / $312.67 / $529.05	Professional		$200.03	$312.67	$529.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.81 / $95.54 / $199.50	Professional	26	$63.81	$95.54	$199.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $126.74 / $209.12 / $348.85	Professional	TC	$126.74	$209.12	$348.85
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $397.09 / $1,026.33 / $1,026.33	Facility		$397.09	$1,026.33	$1,026.33
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $160.72 / $333.40 / $333.40	Facility	26	$160.72	$333.40	$333.40
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,949.29 / $3,949.29 / $3,949.29	Professional		$3,949.29	$3,949.29	$3,949.29
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $433.24 / $540.38 / $540.38	Professional	26	$433.24	$540.38	$540.38
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,033.30 / $1,075.65 / $1,075.65	Professional	TC	$1,033.30	$1,075.65	$1,075.65