Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.40 / $87.40 / $230.48	Facility	26	$87.40	$87.40	$230.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $756.17 / $756.17 / $1,371.59	Professional		$756.17	$756.17	$1,371.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.12 / $87.40 / $262.12	Professional	26	$84.12	$87.40	$262.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $668.77 / $668.77 / $1,223.50	Professional	TC	$668.77	$668.77	$1,223.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $162.06 / $233.16 / $289.69	Professional	26	$162.06	$233.16	$289.69
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,225.83 / $1,804.31 / $2,261.86	Professional	TC	$1,225.83	$1,804.31	$2,261.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.04 / $110.04 / $110.04	Facility	26	$110.04	$110.04	$110.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,025.58 / $1,655.51 / $2,476.13	Professional		$1,025.58	$1,655.51	$2,476.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.93 / $179.62 / $283.38	Professional	26	$111.93	$179.62	$283.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $908.19 / $1,456.09 / $2,192.75	Professional	TC	$908.19	$1,456.09	$2,192.75
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $132.77 / $153.19 / $259.29	Facility	26	$132.77	$153.19	$259.29
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,339.49 / $1,339.49 / $1,339.49	Professional		$1,339.49	$1,339.49	$1,339.49
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $1,186.29 / $1,186.29 / $1,186.29	Professional	TC	$1,186.29	$1,186.29	$1,186.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $2,400.90 / $2,400.90 / $2,400.90	Professional		$2,400.90	$2,400.90	$2,400.90
United Facility/Professional Professional Modifier Low / Median / High Price $886.00 / $1,204.31 / $2,455.71	Professional		$886.00	$1,204.31	$2,455.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.78 / $133.96 / $276.37	Professional	26	$99.78	$133.96	$276.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $784.64 / $1,072.42 / $2,150.01	Professional	TC	$784.64	$1,072.42	$2,150.01
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $229.45 / $229.45 / $468.97	Facility	26	$229.45	$229.45	$468.97
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $5,628.92 / $6,769.20 / $6,769.20	Professional		$5,628.92	$6,769.20	$6,769.20
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $611.21 / $766.58 / $766.58	Professional	26	$611.21	$766.58	$766.58
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $5,017.71 / $6,002.63 / $6,002.63	Professional	TC	$5,017.71	$6,002.63	$6,002.63