Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.56 / $195.19 / $529.11	Facility	26	$58.56	$195.19	$529.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.25 / $279.33 / $1,202.00	Professional		$154.25	$279.33	$1,202.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.56 / $121.30 / $189.26	Professional	26	$58.56	$121.30	$189.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.69 / $201.03 / $648.75	Professional	TC	$95.69	$201.03	$648.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $116.33 / $123.60 / $382.08	Professional		$116.33	$123.60	$382.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.65 / $109.06 / $136.28	Professional	26	$62.65	$109.06	$136.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $282.48 / $301.94 / $319.30	Professional		$282.48	$301.94	$319.30
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.33 / $114.72 / $119.98	Professional	26	$107.33	$114.72	$119.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $175.15 / $187.22 / $198.08	Professional	TC	$175.15	$187.22	$198.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $338.52 / $338.52 / $338.52	Facility	26	$338.52	$338.52	$338.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $225.00 / $360.53 / $472.21	Professional		$225.00	$360.53	$472.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.34 / $133.72 / $172.59	Professional	26	$70.34	$133.72	$172.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.50 / $223.70 / $343.04	Professional	TC	$157.50	$223.70	$343.04
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $571.36 / $571.36 / $571.36	Facility	26	$571.36	$571.36	$571.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $243.92 / $381.50 / $1,670.68	Professional		$243.92	$381.50	$1,670.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $73.52 / $124.15 / $520.49	Professional	26	$73.52	$124.15	$520.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $163.05 / $275.92 / $1,318.41	Professional	TC	$163.05	$275.92	$1,318.41
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $197.11 / $202.85 / $338.52	Facility	26	$197.11	$202.85	$338.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $305.91 / $379.11 / $537.53	Professional		$305.91	$379.11	$537.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.12 / $115.28 / $296.64	Professional		$66.12	$115.28	$296.64
United Facility/Professional Professional Modifier Low / Median / High Price $225.16 / $365.88 / $469.08	Professional		$225.16	$365.88	$469.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.52 / $119.88 / $151.22	Professional	26	$73.52	$119.88	$151.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.05 / $274.98 / $313.55	Professional	TC	$163.05	$274.98	$313.55