Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.38 / $146.53 / $171.49	Facility	26	$103.38	$146.53	$171.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $357.65 / $357.65 / $502.14	Professional		$357.65	$357.65	$502.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.38 / $103.38 / $165.92	Professional	26	$103.38	$103.38	$165.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $254.27 / $254.27 / $360.86	Professional	TC	$254.27	$254.27	$360.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $128.09 / $256.41 / $310.50	Professional	26	$128.09	$256.41	$310.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $253.68 / $333.17 / $578.88	Professional	TC	$253.68	$333.17	$578.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $352.30 / $530.57 / $917.96	Professional		$352.30	$530.57	$917.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.87 / $181.99 / $313.97	Professional	26	$131.87	$181.99	$313.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.77 / $346.16 / $589.44	Professional	TC	$216.77	$346.16	$589.44
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $143.46 / $143.46 / $275.20	Facility	26	$143.46	$143.46	$275.20
Medcost Facility/Professional Professional Modifier Low / Median / High Price $380.23 / $380.23 / $864.69	Professional		$380.23	$380.23	$864.69
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $236.77 / $236.77 / $236.77	Professional	TC	$236.77	$236.77	$236.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $411.80 / $998.00	Professional		$3.00	$411.80	$998.00
United Facility/Professional Professional Modifier Low / Median / High Price $296.24 / $428.42 / $978.64	Professional		$296.24	$428.42	$978.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $106.47 / $144.51 / $316.44	Professional	26	$106.47	$144.51	$316.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $191.01 / $275.64 / $623.91	Professional	TC	$191.01	$275.64	$623.91
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $243.55 / $507.92 / $507.92	Facility	26	$243.55	$507.92	$507.92
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,451.44 / $2,864.93 / $2,864.93	Professional		$2,451.44	$2,864.93	$2,864.93
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $764.48 / $859.80 / $859.80	Professional	26	$764.48	$859.80	$859.80
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,717.44 / $2,005.13 / $2,005.13	Professional	TC	$1,717.44	$2,005.13	$2,005.13