Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.52 / $58.52 / $99.77	Facility	26	$58.52	$58.52	$99.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.45 / $127.38 / $223.06	Professional		$111.45	$127.38	$223.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.53 / $59.35 / $91.76	Professional	26	$54.53	$59.35	$91.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.56 / $59.44 / $131.93	Professional	TC	$54.56	$59.44	$131.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $156.93 / $156.93 / $156.93	Professional		$156.93	$156.93	$156.93
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $84.16 / $133.28 / $179.85	Professional	26	$84.16	$133.28	$179.85
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $135.10 / $202.02 / $270.05	Professional	TC	$135.10	$202.02	$270.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.87 / $67.87 / $67.87	Facility	26	$67.87	$67.87	$67.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.16 / $213.29 / $317.50	Professional		$129.16	$213.29	$317.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.16 / $89.67 / $146.63	Professional	26	$61.16	$89.67	$146.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.33 / $113.27 / $200.17	Professional	TC	$62.33	$113.27	$200.17
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $67.36 / $103.00 / $132.88	Facility	26	$67.36	$103.00	$132.88
Medcost Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $153.00 / $416.13	Professional		$75.00	$153.00	$416.13
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $67.36 / $103.00 / $215.35	Professional	26	$67.36	$103.00	$215.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $164.60 / $271.89 / $345.50	Professional		$164.60	$271.89	$345.50
United Facility/Professional Professional Modifier Low / Median / High Price $118.91 / $179.40 / $298.32	Professional		$118.91	$179.40	$298.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.60 / $79.64 / $155.63	Professional	26	$57.60	$79.64	$155.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.33 / $98.38 / $157.08	Professional	TC	$57.33	$98.38	$157.08
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $139.35 / $352.88 / $352.88	Facility	26	$139.35	$352.88	$352.88
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,010.47 / $1,010.47 / $1,089.32	Professional		$1,010.47	$1,010.47	$1,089.32
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $369.36 / $369.36 / $471.98	Professional	26	$369.36	$369.36	$471.98
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $681.15 / $681.15 / $727.29	Professional	TC	$681.15	$681.15	$727.29