Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.39 / $500.64 / $850.80	Facility		$100.39	$500.64	$850.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.19 / $22.89 / $38.22	Facility	26	$21.19	$22.89	$38.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $94.98 / $369.30 / $637.54	Facility	TC	$94.98	$369.30	$637.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.63 / $123.43 / $332.49	Professional		$30.63	$123.43	$332.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.87 / $25.67 / $90.29	Professional	26	$19.87	$25.67	$90.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.76 / $102.26 / $207.06	Professional	TC	$90.76	$102.26	$207.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.35 / $146.61 / $240.05	Professional		$85.35	$146.61	$240.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.52 / $30.16 / $43.63	Professional	26	$15.52	$30.16	$43.63
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $69.83 / $109.36 / $153.63	Professional	TC	$69.83	$109.36	$153.63
BCBS Facility/Professional Facility Modifier Low / Median / High Price $216.52 / $259.82 / $325.68	Facility		$216.52	$259.82	$325.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.35 / $57.35 / $57.35	Professional		$57.35	$57.35	$57.35
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.82 / $48.02 / $64.81	Professional	26	$29.82	$48.02	$64.81
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $130.94 / $182.07 / $269.55	Professional	TC	$130.94	$182.07	$269.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.07 / $142.47 / $262.08	Facility		$120.07	$142.47	$262.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.98 / $23.98 / $23.98	Facility	26	$23.98	$23.98	$23.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $109.98 / $109.98 / $109.98	Facility	TC	$109.98	$109.98	$109.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.60 / $198.68 / $302.83	Professional		$124.60	$198.68	$302.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.95 / $32.76 / $52.66	Professional	26	$21.95	$32.76	$52.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.74 / $166.58 / $251.35	Professional	TC	$100.74	$166.58	$251.35
Medcost Facility/Professional Facility Modifier Low / Median / High Price $116.19 / $186.71 / $285.66	Facility		$116.19	$186.71	$285.66
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $24.24 / $45.71 / $66.00	Facility	26	$24.24	$45.71	$66.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $90.46 / $152.76 / $240.34	Facility	TC	$90.46	$152.76	$240.34
Medcost Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $125.00 / $427.58	Professional		$28.00	$125.00	$427.58
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $24.24 / $66.00 / $78.02	Professional	26	$24.24	$66.00	$78.02
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $184.91 / $324.00 / $641.37	Professional	50	$184.91	$324.00	$641.37
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,877.03 / $3,057.33 / $8,635.71	Facility		$2,877.03	$3,057.33	$8,635.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.23 / $120.92 / $204.31	Professional		$26.23	$120.92	$204.31
United Facility/Professional Professional Modifier Low / Median / High Price $116.34 / $172.81 / $281.13	Professional		$116.34	$172.81	$281.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.68 / $29.72 / $58.78	Professional	26	$20.68	$29.72	$58.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.19 / $132.68 / $247.65	Professional	TC	$93.19	$132.68	$247.65
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $265.10 / $635.03 / $635.03	Facility		$265.10	$635.03	$635.03
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $54.46 / $106.00 / $107.00	Facility	26	$54.46	$106.00	$107.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $225.94 / $534.14 / $534.14	Facility	TC	$225.94	$534.14	$534.14
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $996.30 / $996.30 / $1,081.80	Professional		$996.30	$996.30	$1,081.80
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $237.75 / $237.75 / $237.75	Professional	26	$237.75	$237.75	$237.75
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $828.38 / $828.38 / $952.89	Professional	TC	$828.38	$828.38	$952.89