Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $549.54 / $758.58	Facility		$181.97	$549.54	$758.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $38.90 / $64.57	Facility	26	$37.15	$38.90	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $234.42 / $524.81	Professional		$158.49	$234.42	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $52.48 / $131.83	Professional	26	$34.67	$52.48	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $165.96 / $338.84	Professional	TC	$131.83	$165.96	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $338.84	Professional		$112.20	$158.49	$338.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $42.66 / $58.88	Professional	26	$29.51	$42.66	$58.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	TC	$123.03	$123.03	$123.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $407.38 / $549.54	Facility		$398.11	$407.38	$549.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Professional		$83.18	$83.18	$83.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $69.18 / $114.82	Professional	26	$43.65	$69.18	$114.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $257.04 / $389.05	Professional	TC	$186.21	$257.04	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $281.84 / $501.19	Facility		$199.53	$281.84	$501.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $43.65 / $63.10	Facility	26	$9.33	$43.65	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $275.42 / $478.63	Professional		$186.21	$275.42	$478.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $50.12 / $89.13	Professional	26	$35.48	$50.12	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $223.87 / $398.11	Professional	TC	$147.91	$223.87	$398.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $288.40 / $354.81	Professional		$245.47	$288.40	$354.81
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $52.48 / $70.79	Professional	26	$48.98	$52.48	$70.79
Medcost Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $251.19 / $436.52	Facility		$173.78	$251.19	$436.52
Medcost Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $338.84 / $724.44	Professional		$199.53	$338.84	$724.44
United Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $158.49 / $251.19	Facility		$39.81	$158.49	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $229.09 / $416.87	Professional		$177.83	$229.09	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $40.74 / $81.28	Professional	26	$31.62	$40.74	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $190.55 / $338.84	Professional	TC	$141.25	$190.55	$338.84
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Facility		$1,174.90	$1,174.90	$1,174.90
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $234.42 / $234.42 / $234.42	Facility	26	$234.42	$234.42	$234.42
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Professional		$1,513.56	$1,513.56	$1,513.56
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $363.08 / $363.08 / $363.08	Professional	26	$363.08	$363.08	$363.08
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,202.26 / $1,318.26 / $1,318.26	Professional	TC	$1,202.26	$1,318.26	$1,318.26