Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.48 / $35.50 / $56.50	Facility	26	$28.48	$35.50	$56.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.02 / $79.14 / $179.30	Professional		$66.02	$79.14	$179.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.21 / $29.80 / $52.02	Professional	26	$27.21	$29.80	$52.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $217.92 / $217.92 / $217.92	Professional	50	$217.92	$217.92	$217.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.54 / $47.00 / $79.63	Professional	TC	$37.54	$47.00	$79.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.25 / $88.25 / $88.25	Professional		$88.25	$88.25	$88.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.89 / $67.75 / $98.30	Professional	26	$45.89	$67.75	$98.30
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.67 / $109.14 / $161.11	Professional	TC	$61.67	$109.14	$161.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.24 / $36.24 / $36.24	Facility	26	$36.24	$36.24	$36.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.18 / $127.44 / $235.54	Professional		$81.18	$127.44	$235.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.31 / $50.53 / $89.45	Professional	26	$31.31	$50.53	$89.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.28 / $79.62 / $144.27	Professional	TC	$49.28	$79.62	$144.27
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $46.00 / $48.09 / $79.76	Facility	26	$46.00	$48.09	$79.76
Medcost Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $115.52 / $269.95	Professional		$45.00	$115.52	$269.95
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $48.09 / $48.09 / $58.00	Professional	26	$48.09	$48.09	$58.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $173.28 / $246.00 / $404.95	Professional	50	$173.28	$246.00	$404.95
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $153.49 / $153.49 / $153.49	Professional	TC	$153.49	$153.49	$153.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $82.00 / $142.30 / $201.70	Professional		$82.00	$142.30	$201.70
United Facility/Professional Professional Modifier Low / Median / High Price $82.05 / $115.03 / $218.75	Professional		$82.05	$115.03	$218.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.29 / $43.01 / $88.28	Professional	26	$31.29	$43.01	$88.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.06 / $71.06 / $129.19	Professional	TC	$51.06	$71.06	$129.19
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $93.26 / $161.31 / $161.31	Facility	26	$93.26	$161.31	$161.31
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $603.17 / $603.17 / $618.45	Professional		$603.17	$603.17	$618.45
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $335.18 / $335.18 / $335.18	Professional	26	$335.18	$335.18	$335.18
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $360.07 / $360.07 / $360.45	Professional	TC	$360.07	$360.07	$360.45