Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.74 / $265.04 / $369.79	Facility		$103.74	$265.04	$369.79
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.93 / $23.39 / $39.22	Facility	26	$12.93	$23.39	$39.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.01 / $126.72 / $267.41	Professional		$107.01	$126.72	$267.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $23.39 / $42.92	Professional	26	$11.77	$23.39	$42.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.35 / $103.93 / $202.30	Professional	TC	$95.35	$103.93	$202.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.28 / $201.91 / $267.86	Professional		$104.28	$201.91	$267.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.49 / $35.51 / $47.18	Professional	26	$33.49	$35.51	$47.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.29 / $70.00 / $70.00	Professional		$32.29	$70.00	$70.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.14 / $26.89 / $41.21	Professional	26	$16.14	$26.89	$41.21
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $122.16 / $178.53 / $262.39	Professional	TC	$122.16	$178.53	$262.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.68 / $180.05 / $519.53	Facility		$147.68	$180.05	$519.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $26.75 / $26.75	Facility	26	$26.75	$26.75	$26.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.44 / $213.70 / $383.12	Professional		$145.44	$213.70	$383.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.57 / $25.91 / $54.47	Professional	26	$13.57	$25.91	$54.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.01 / $191.01 / $329.45	Professional	TC	$123.01	$191.01	$329.45
Medcost Facility/Professional Facility Modifier Low / Median / High Price $111.99 / $151.79 / $247.40	Facility		$111.99	$151.79	$247.40
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.97 / $22.00 / $30.84	Facility	26	$12.97	$22.00	$30.84
Medcost Facility/Professional Professional Modifier Low / Median / High Price $29.00 / $168.00 / $251.00	Professional		$29.00	$168.00	$251.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.17 / $189.97 / $384.00	Professional		$39.17	$189.97	$384.00
United Facility/Professional Professional Modifier Low / Median / High Price $141.29 / $182.32 / $309.23	Professional		$141.29	$182.32	$309.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.91 / $23.10 / $38.51	Professional	26	$11.91	$23.10	$38.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $118.85 / $163.19 / $279.58	Professional	TC	$118.85	$163.19	$279.58
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $263.79 / $708.89 / $708.89	Facility		$263.79	$708.89	$708.89
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $52.72 / $107.64 / $107.64	Facility	26	$52.72	$107.64	$107.64
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,122.59 / $1,230.05 / $1,230.05	Professional		$1,122.59	$1,230.05	$1,230.05
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $198.13 / $198.13 / $198.13	Professional	26	$198.13	$198.13	$198.13
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $934.20 / $1,157.00 / $1,157.00	Professional	TC	$934.20	$1,157.00	$1,157.00