Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.63 / $303.17 / $344.25	Facility		$177.63	$303.17	$344.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.94 / $23.22 / $39.97	Facility	26	$21.94	$23.22	$39.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.86 / $129.78 / $321.79	Professional		$103.86	$129.78	$321.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $23.22 / $64.61	Professional	26	$20.50	$23.22	$64.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.13 / $101.24 / $178.41	Professional	TC	$91.13	$101.24	$178.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $157.72 / $157.72 / $201.06	Professional		$157.72	$157.72	$201.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.30 / $37.52 / $48.24	Professional	26	$17.30	$37.52	$48.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $246.02 / $264.45 / $325.68	Facility		$246.02	$264.45	$325.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $57.00 / $57.00	Professional		$57.00	$57.00	$57.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.15 / $47.26 / $69.47	Professional	26	$32.15	$47.26	$69.47
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $127.22 / $185.50 / $269.92	Professional	TC	$127.22	$185.50	$269.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.07 / $136.69 / $251.41	Facility		$120.07	$136.69	$251.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.06 / $27.06	Facility	26	$27.06	$27.06	$27.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.27 / $192.38 / $299.63	Professional		$127.27	$192.38	$299.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.84 / $33.95 / $56.99	Professional	26	$22.84	$33.95	$56.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.50 / $159.79 / $243.09	Professional	TC	$102.50	$159.79	$243.09
Medcost Facility/Professional Facility Modifier Low / Median / High Price $114.35 / $184.00 / $268.72	Facility		$114.35	$184.00	$268.72
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $23.24 / $38.00 / $51.04	Facility	26	$23.24	$38.00	$51.04
Medcost Facility/Professional Professional Modifier Low / Median / High Price $31.00 / $122.25 / $420.81	Professional		$31.00	$122.25	$420.81
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $23.24 / $23.24 / $38.00	Professional	26	$23.24	$23.24	$38.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $335.36 / $335.36 / $335.36	Professional	TC	$335.36	$335.36	$335.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.19 / $166.90 / $322.39	Professional		$36.19	$166.90	$322.39
United Facility/Professional Facility Modifier Low / Median / High Price $26.29 / $110.74 / $159.29	Facility		$26.29	$110.74	$159.29
United Facility/Professional Professional Modifier Low / Median / High Price $115.55 / $162.59 / $311.14	Professional		$115.55	$162.59	$311.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.97 / $27.85 / $54.86	Professional	26	$20.97	$27.85	$54.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.17 / $137.49 / $248.56	Professional	TC	$91.17	$137.49	$248.56
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $262.18 / $623.15 / $623.15	Facility		$262.18	$623.15	$623.15
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $53.90 / $111.06 / $111.06	Facility	26	$53.90	$111.06	$111.06
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $983.25 / $983.25 / $1,040.97	Professional		$983.25	$983.25	$1,040.97
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $217.94 / $217.94 / $217.94	Professional	26	$217.94	$217.94	$217.94
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $794.40 / $794.40 / $914.23	Professional	TC	$794.40	$794.40	$914.23