Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.76 / $96.70 / $351.67	Facility	26	$38.76	$96.70	$351.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.20 / $199.53 / $650.00	Professional		$103.20	$199.53	$650.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.08 / $54.10 / $123.00	Professional	26	$37.08	$54.10	$123.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.20 / $156.34 / $414.16	Professional	TC	$63.20	$156.34	$414.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.15 / $83.04 / $254.11	Professional		$78.15	$83.04	$254.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $53.68 / $90.35	Professional	26	$38.90	$53.68	$90.35
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $67.88 / $67.88 / $125.46	Professional	TC	$67.88	$67.88	$125.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.68 / $201.68 / $213.62	Professional		$188.68	$201.68	$213.62
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.84 / $75.70 / $80.23	Professional	26	$70.84	$75.70	$80.23
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $117.84 / $125.95 / $132.00	Professional	TC	$117.84	$125.95	$132.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $223.44 / $223.44 / $223.44	Facility	26	$223.44	$223.44	$223.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.91 / $242.23 / $367.96	Professional		$130.91	$242.23	$367.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.13 / $88.30 / $114.42	Professional	26	$51.13	$88.30	$114.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.78 / $151.53 / $232.09	Professional	TC	$79.78	$151.53	$232.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $268.85 / $376.16 / $376.16	Facility	26	$268.85	$376.16	$376.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $140.44 / $231.29 / $1,267.82	Professional		$140.44	$231.29	$1,267.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $49.12 / $78.45 / $118.49	Professional	26	$49.12	$78.45	$118.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $86.69 / $146.72 / $1,108.00	Professional	TC	$86.69	$146.72	$1,108.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $131.63 / $135.47 / $223.44	Facility	26	$131.63	$135.47	$223.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $204.33 / $253.93 / $384.00	Professional		$204.33	$253.93	$384.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.56 / $100.16 / $178.79	Professional		$40.56	$100.16	$178.79
United Facility/Professional Professional Modifier Low / Median / High Price $140.44 / $227.47 / $332.70	Professional		$140.44	$227.47	$332.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.12 / $80.63 / $100.53	Professional	26	$49.12	$80.63	$100.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.03 / $136.61 / $190.59	Professional	TC	$80.03	$136.61	$190.59