Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.32 / $50.32 / $50.32	Facility	26	$50.32	$50.32	$50.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $308.27 / $389.69 / $667.49	Professional		$308.27	$389.69	$667.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.32 / $58.78 / $85.48	Professional	26	$50.32	$58.78	$85.48
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $154.13 / $191.88 / $284.00	Professional	52	$154.13	$191.88	$284.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.94 / $335.36 / $581.17	Professional	TC	$257.94	$335.36	$581.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $560.60 / $560.60 / $614.61	Professional		$560.60	$560.60	$614.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.54 / $76.36 / $204.76	Professional	26	$54.54	$76.36	$204.76
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $319.18 / $476.23 / $1,194.17	Professional	TC	$319.18	$476.23	$1,194.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.31 / $67.31 / $67.31	Facility	26	$67.31	$67.31	$67.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $418.27 / $670.21 / $1,134.78	Professional		$418.27	$670.21	$1,134.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.73 / $103.60 / $165.58	Professional	26	$64.73	$103.60	$165.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $347.85 / $568.28 / $977.59	Professional	TC	$347.85	$568.28	$977.59
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $68.67 / $103.00 / $136.25	Facility	26	$68.67	$103.00	$136.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $502.00 / $581.00	Professional		$79.00	$502.00	$581.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $83.67 / $83.67 / $83.67	Professional	26	$83.67	$83.67	$83.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.69 / $538.89 / $682.37	Professional		$89.69	$538.89	$682.37
United Facility/Professional Professional Modifier Low / Median / High Price $388.00 / $559.79 / $1,028.05	Professional		$388.00	$559.79	$1,028.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.21 / $85.17 / $156.16	Professional	26	$60.21	$85.17	$156.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $326.33 / $460.01 / $924.87	Professional	TC	$326.33	$460.01	$924.87
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $135.00 / $495.00 / $495.00	Facility	26	$135.00	$495.00	$495.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,986.11 / $2,986.11 / $3,500.93	Professional		$2,986.11	$2,986.11	$3,500.93
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $873.43 / $873.43 / $873.43	Professional	26	$873.43	$873.43	$873.43
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,558.09 / $2,558.09 / $3,038.18	Professional	TC	$2,558.09	$2,558.09	$3,038.18