Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.83 / $12.86 / $19.57	Facility	26	$11.83	$12.86	$19.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.52 / $88.54 / $275.00	Professional		$86.52	$88.54	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.45 / $11.83 / $55.00	Professional	26	$10.45	$11.83	$55.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.44 / $76.72 / $220.00	Professional	TC	$76.44	$76.72	$220.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.42 / $28.42 / $28.42	Professional		$28.42	$28.42	$28.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.76 / $25.72 / $34.59	Professional	26	$18.76	$25.72	$34.59
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.24 / $145.77 / $183.72	Professional	TC	$84.24	$145.77	$183.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.91 / $203.40 / $346.56	Professional		$121.91	$203.40	$346.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.28 / $18.76 / $33.67	Professional	26	$11.28	$18.76	$33.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.67 / $180.26 / $309.23	Professional	TC	$107.67	$180.26	$309.23
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $13.74 / $19.36 / $36.34	Facility	26	$13.74	$19.36	$36.34
Medcost Facility/Professional Professional Modifier Low / Median / High Price $16.00 / $127.00 / $143.00	Professional		$16.00	$127.00	$143.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $43.53 / $43.53 / $43.53	Professional	26	$43.53	$43.53	$43.53
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $100.49 / $100.49 / $111.76	Professional	TC	$100.49	$100.49	$111.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $151.30 / $251.60 / $355.90	Professional		$151.30	$251.60	$355.90
United Facility/Professional Professional Modifier Low / Median / High Price $108.58 / $168.02 / $298.60	Professional		$108.58	$168.02	$298.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.59 / $15.89 / $32.75	Professional	26	$11.59	$15.89	$32.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.26 / $148.66 / $268.08	Professional	TC	$96.26	$148.66	$268.08
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $85.36 / $107.60 / $107.60	Facility	26	$85.36	$107.60	$107.60
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $902.92 / $902.92 / $902.92	Professional		$902.92	$902.92	$902.92
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $270.04 / $270.04 / $270.04	Professional	26	$270.04	$270.04	$270.04
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $845.22 / $845.22 / $845.22	Professional	TC	$845.22	$845.22	$845.22