Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $294.72 / $438.20	Facility		$142.63	$294.72	$438.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.42 / $36.49 / $85.19	Facility	26	$34.42	$36.49	$85.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.03 / $211.81 / $558.00	Professional		$131.03	$211.81	$558.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.43 / $54.92 / $210.38	Professional	26	$34.43	$54.92	$210.38
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $90.18 / $96.15 / $248.40	Professional	52	$90.18	$96.15	$248.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.60 / $134.55 / $201.02	Professional	TC	$96.60	$134.55	$201.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.43 / $170.72 / $276.61	Professional		$92.43	$170.72	$276.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.39 / $56.74 / $72.31	Professional	26	$53.39	$56.74	$72.31
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $27.19 / $69.15 / $69.15	Professional	52	$27.19	$69.15	$69.15
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $152.87 / $152.87 / $152.87	Professional	TC	$152.87	$152.87	$152.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.05 / $169.05 / $169.05	Professional		$169.05	$169.05	$169.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.22 / $59.20 / $160.84	Professional	26	$36.22	$59.20	$160.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.70 / $158.83 / $375.09	Professional	TC	$80.70	$158.83	$375.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $250.00 / $250.00	Facility		$250.00	$250.00	$250.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.86 / $44.86 / $44.86	Facility	26	$44.86	$44.86	$44.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $284.06 / $458.39	Professional		$169.82	$284.06	$458.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.77 / $79.52 / $133.66	Professional	26	$45.77	$79.52	$133.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $122.74 / $200.49 / $324.74	Professional	TC	$122.74	$200.49	$324.74
Medcost Facility/Professional Facility Modifier Low / Median / High Price $128.62 / $208.10 / $272.47	Facility		$128.62	$208.10	$272.47
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $59.01 / $68.16 / $107.79	Facility	26	$59.01	$68.16	$107.79
Medcost Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $157.00 / $223.00	Professional		$66.00	$157.00	$223.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $169.75 / $169.75 / $169.75	Professional	TC	$169.75	$169.75	$169.75
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $553.54 / $553.54 / $553.54	Facility		$553.54	$553.54	$553.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.03 / $154.27 / $216.11	Professional		$56.03	$154.27	$216.11
United Facility/Professional Professional Modifier Low / Median / High Price $151.46 / $228.02 / $411.89	Professional		$151.46	$228.02	$411.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.56 / $66.70 / $112.17	Professional	26	$41.56	$66.70	$112.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.89 / $163.66 / $297.70	Professional	TC	$109.89	$163.66	$297.70
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $306.17 / $682.58 / $682.58	Facility		$306.17	$682.58	$682.58
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $86.48 / $188.81 / $188.81	Facility	26	$86.48	$188.81	$188.81
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,027.63 / $2,210.79 / $2,210.79	Professional		$1,027.63	$2,210.79	$2,210.79
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $269.14 / $308.02 / $308.02	Professional	26	$269.14	$308.02	$308.02
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $767.60 / $2,112.67 / $2,112.67	Professional	TC	$767.60	$2,112.67	$2,112.67