Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.22 / $38.90 / $114.82	Facility	26	$16.22	$38.90	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $57.54 / $169.82	Professional		$38.90	$57.54	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $26.92 / $34.67	Professional	26	$10.96	$26.92	$34.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $38.02 / $83.18	Professional	TC	$27.54	$38.02	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $34.67 / $75.86	Professional		$29.51	$34.67	$75.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $14.13 / $26.92	Professional	26	$9.12	$14.13	$26.92
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $25.12 / $74.13	Professional	TC	$25.12	$25.12	$74.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $85.11 / $89.13	Professional		$77.62	$85.11	$89.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $23.44 / $25.12	Professional	26	$21.88	$23.44	$25.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $61.66 / $64.57	Professional	TC	$57.54	$61.66	$64.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $69.18 / $69.18	Facility	26	$69.18	$69.18	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $89.13 / $141.25	Professional		$36.31	$89.13	$141.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $25.12 / $35.48	Professional	26	$11.48	$25.12	$35.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $64.57 / $104.71	Professional	TC	$26.30	$64.57	$104.71
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $69.18 / $309.03	Professional		$46.77	$69.18	$309.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $20.89 / $95.50	Professional	26	$15.49	$20.89	$95.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $48.98 / $251.19	Professional	TC	$33.11	$48.98	$251.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $100.00 / $158.49	Professional		$89.13	$100.00	$158.49
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $27.54 / $41.69	Professional	26	$23.99	$27.54	$41.69
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $74.13 / $117.49	Professional	TC	$64.57	$74.13	$117.49
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $69.18 / $69.18	Facility	26	$69.18	$69.18	$69.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $77.62 / $158.49	Professional		$72.44	$77.62	$158.49
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $25.12 / $41.69	Professional	26	$19.95	$25.12	$41.69
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $52.48 / $117.49	Professional	TC	$52.48	$52.48	$117.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $35.48 / $79.43	Professional		$12.88	$35.48	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $64.57 / $102.33	Professional		$44.67	$64.57	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $20.42 / $32.36	Professional	26	$13.49	$20.42	$32.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $44.67 / $74.13	Professional	TC	$30.90	$44.67	$74.13