Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $224.59 / $689.04 / $1,217.77	Facility		$224.59	$689.04	$1,217.77
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.27 / $34.18 / $56.04	Facility	26	$33.27	$34.18	$56.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $149.90 / $756.44 / $922.55	Facility	TC	$149.90	$756.44	$922.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.64 / $208.83 / $490.62	Professional		$166.64	$208.83	$490.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.75 / $37.18 / $136.63	Professional	26	$30.75	$37.18	$136.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $149.90 / $169.96 / $323.77	Professional	TC	$149.90	$169.96	$323.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $133.31 / $159.53 / $328.60	Professional		$133.31	$159.53	$328.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.01 / $46.80 / $67.52	Professional	26	$24.01	$46.80	$67.52
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $203.24 / $207.37 / $264.33	Professional	TC	$203.24	$207.37	$264.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $388.62 / $412.00 / $507.39	Facility		$388.62	$412.00	$507.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.93 / $86.93 / $86.93	Professional		$86.93	$86.93	$86.93
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.62 / $72.95 / $99.34	Professional	26	$45.62	$72.95	$99.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $205.38 / $290.43 / $432.87	Professional	TC	$205.38	$290.43	$432.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $209.15 / $276.18 / $414.75	Facility		$209.15	$276.18	$414.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.51 / $37.51 / $37.51	Facility	26	$37.51	$37.51	$37.51
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $172.98 / $172.98 / $172.98	Facility	TC	$172.98	$172.98	$172.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.34 / $305.70 / $481.51	Professional		$200.34	$305.70	$481.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.75 / $49.91 / $81.84	Professional	26	$33.75	$49.91	$81.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $163.34 / $259.11 / $396.76	Professional	TC	$163.34	$259.11	$396.76
Medcost Facility/Professional Facility Modifier Low / Median / High Price $183.17 / $282.68 / $430.45	Facility		$183.17	$282.68	$430.45
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $35.94 / $75.98 / $101.00	Facility	26	$35.94	$75.98	$101.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $143.16 / $231.55 / $387.40	Facility	TC	$143.16	$231.55	$387.40
Medcost Facility/Professional Professional Modifier Low / Median / High Price $44.00 / $203.00 / $674.07	Professional		$44.00	$203.00	$674.07
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $35.94 / $35.94 / $101.00	Professional	26	$35.94	$35.94	$101.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $551.63 / $551.63 / $551.63	Professional	TC	$551.63	$551.63	$551.63
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,114.44 / $2,310.12 / $6,223.16	Facility		$2,114.44	$2,310.12	$6,223.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $190.04 / $319.64	Professional		$41.00	$190.04	$319.64
United Facility/Professional Professional Modifier Low / Median / High Price $186.20 / $258.89 / $449.94	Professional		$186.20	$258.89	$449.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.27 / $42.52 / $87.82	Professional	26	$31.27	$42.52	$87.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.91 / $221.73 / $367.08	Professional	TC	$151.91	$221.73	$367.08
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $401.27 / $991.94 / $991.94	Facility		$401.27	$991.94	$991.94
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $84.57 / $212.00 / $212.00	Facility	26	$84.57	$212.00	$212.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $341.00 / $836.05 / $836.05	Facility	TC	$341.00	$836.05	$836.05
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,556.63 / $1,556.63 / $1,622.16	Professional		$1,556.63	$1,556.63	$1,622.16
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $889.65 / $889.65 / $889.65	Professional	26	$889.65	$889.65	$889.65
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,296.30 / $1,296.30 / $1,426.64	Professional	TC	$1,296.30	$1,296.30	$1,426.64