Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $1,004.56	Facility		$63.10	$63.10	$1,004.56
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.18 / $18.18 / $18.79	Facility	26	$18.18	$18.18	$18.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.21 / $74.42 / $153.12	Professional		$62.21	$74.42	$153.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.37 / $18.18 / $31.85	Professional	26	$16.37	$18.18	$31.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.81 / $52.21 / $134.71	Professional	TC	$44.81	$52.21	$134.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.98 / $59.98 / $59.98	Professional		$59.98	$59.98	$59.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $200.25 / $205.59 / $205.59	Professional		$200.25	$205.59	$205.59
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.93 / $27.77 / $58.75	Professional	26	$16.93	$27.77	$58.75
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.05 / $64.58 / $269.08	Professional	TC	$43.05	$64.58	$269.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.31 / $75.31 / $75.31	Facility		$75.31	$75.31	$75.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.65 / $20.65 / $20.65	Facility	26	$20.65	$20.65	$20.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.84 / $126.01 / $272.25	Professional		$67.84	$126.01	$272.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.80 / $27.08 / $48.55	Professional	26	$17.80	$27.08	$48.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.23 / $99.71 / $228.24	Professional	TC	$49.23	$99.71	$228.24
Medcost Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $77.69 / $166.92	Facility		$60.00	$77.69	$166.92
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $18.52 / $24.00 / $32.95	Facility	26	$18.52	$24.00	$32.95
Medcost Facility/Professional Professional Modifier Low / Median / High Price $24.00 / $114.61 / $162.00	Professional		$24.00	$114.61	$162.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $18.52 / $18.52 / $18.52	Professional	26	$18.52	$18.52	$18.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.22 / $68.53 / $116.26	Professional		$26.22	$68.53	$116.26
United Facility/Professional Professional Modifier Low / Median / High Price $63.86 / $110.93 / $232.89	Professional		$63.86	$110.93	$232.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.64 / $23.56 / $46.03	Professional	26	$16.64	$23.56	$46.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.25 / $89.96 / $176.30	Professional	TC	$45.25	$89.96	$176.30
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $213.52 / $353.50 / $353.50	Facility		$213.52	$353.50	$353.50
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $50.74 / $134.26 / $134.26	Facility	26	$50.74	$134.26	$134.26
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $611.90 / $611.90 / $803.55	Professional		$611.90	$611.90	$803.55
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $416.07 / $416.07 / $416.07	Professional	26	$416.07	$416.07	$416.07
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $578.59 / $578.59 / $578.59	Professional	TC	$578.59	$578.59	$578.59