Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $235.69 / $654.08 / $915.61	Facility		$235.69	$654.08	$915.61
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.03 / $37.70 / $54.97	Facility	26	$29.03	$37.70	$54.97
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $198.00 / $231.43 / $767.00	Facility	TC	$198.00	$231.43	$767.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.31 / $235.87 / $520.54	Professional		$189.31	$235.87	$520.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $37.70 / $103.33	Professional	26	$26.96	$37.70	$103.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $198.00 / $407.88	Professional	TC	$162.34	$198.00	$407.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $170.51 / $181.17 / $330.48	Professional		$170.51	$181.17	$330.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.18 / $53.10 / $77.31	Professional	26	$27.18	$53.10	$77.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $143.02 / $146.22 / $223.98	Professional	TC	$143.02	$146.22	$223.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $342.02 / $410.42 / $507.39	Facility		$342.02	$410.42	$507.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.40 / $74.40 / $74.40	Professional		$74.40	$74.40	$74.40
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.96 / $60.64 / $107.65	Professional	26	$41.96	$60.64	$107.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $213.23 / $293.93 / $590.78	Professional	TC	$213.23	$293.93	$590.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $268.80 / $296.99 / $541.96	Facility		$268.80	$296.99	$541.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.91 / $42.91 / $42.91	Facility	26	$42.91	$42.91	$42.91
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $227.42 / $227.42 / $227.42	Facility	TC	$227.42	$227.42	$227.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.51 / $388.65 / $624.26	Professional		$251.51	$388.65	$624.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.96 / $50.07 / $86.48	Professional	26	$32.96	$50.07	$86.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.37 / $334.40 / $533.80	Professional	TC	$213.37	$334.40	$533.80
Medcost Facility/Professional Facility Modifier Low / Median / High Price $188.24 / $321.45 / $523.17	Facility		$188.24	$321.45	$523.17
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $30.48 / $49.00 / $88.60	Facility	26	$30.48	$49.00	$88.60
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $187.07 / $300.29 / $518.19	Facility	TC	$187.07	$300.29	$518.19
Medcost Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $274.00 / $867.34	Professional		$50.00	$274.00	$867.34
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $30.48 / $49.00 / $138.74	Professional	26	$30.48	$49.00	$138.74
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $282.36 / $504.00 / $1,301.01	Professional	50	$282.36	$504.00	$1,301.01
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $835.36 / $912.65 / $2,569.96	Facility		$835.36	$912.65	$2,569.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.50 / $311.64 / $446.70	Professional		$56.50	$311.64	$446.70
United Facility/Professional Professional Modifier Low / Median / High Price $242.11 / $327.70 / $588.59	Professional		$242.11	$327.70	$588.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.73 / $44.67 / $98.12	Professional	26	$27.73	$44.67	$98.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $203.21 / $287.58 / $535.83	Professional	TC	$203.21	$287.58	$535.83
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $473.60 / $1,272.43 / $1,272.43	Facility		$473.60	$1,272.43	$1,272.43
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $86.56 / $205.00 / $205.00	Facility	26	$86.56	$205.00	$205.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $399.93 / $1,093.97 / $1,093.97	Facility	TC	$399.93	$1,093.97	$1,093.97
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,995.00 / $1,995.00 / $2,005.68	Professional		$1,995.00	$1,995.00	$2,005.68
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $399.57 / $399.57 / $399.57	Professional	26	$399.57	$399.57	$399.57
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,696.35 / $1,696.35 / $1,840.24	Professional	TC	$1,696.35	$1,696.35	$1,840.24