Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.52 / $337.53 / $568.94	Facility	26	$51.52	$337.53	$568.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.46 / $180.75 / $1,298.47	Professional		$175.46	$180.75	$1,298.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.52 / $141.77 / $233.61	Professional	26	$51.52	$141.77	$233.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.94 / $127.36 / $978.84	Professional	TC	$123.94	$127.36	$978.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $55.11 / $55.33 / $98.40	Professional	26	$55.11	$55.33	$98.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $320.35 / $342.42 / $363.19	Professional		$320.35	$342.42	$363.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.35 / $100.86 / $106.65	Professional	26	$94.35	$100.86	$106.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $225.97 / $241.53 / $256.56	Professional	TC	$225.97	$241.53	$256.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $297.66 / $297.66 / $297.66	Facility	26	$297.66	$297.66	$297.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $408.58 / $597.67	Professional		$275.00	$408.58	$597.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.50 / $117.41 / $160.57	Professional	26	$82.50	$117.41	$160.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $192.50 / $288.20 / $441.53	Professional	TC	$192.50	$288.20	$441.53
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $502.08 / $502.08 / $502.08	Facility	26	$502.08	$502.08	$502.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $271.30 / $430.00 / $1,940.92	Professional		$271.30	$430.00	$1,940.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $71.58 / $109.23 / $556.79	Professional	26	$71.58	$109.23	$556.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $199.72 / $337.99 / $1,561.11	Professional	TC	$199.72	$337.99	$1,561.11
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $211.88 / $218.05 / $297.66	Facility	26	$211.88	$218.05	$297.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $346.92 / $528.33 / $621.53	Professional		$346.92	$528.33	$621.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.09 / $137.36 / $335.56	Professional		$58.09	$137.36	$335.56
United Facility/Professional Professional Modifier Low / Median / High Price $271.30 / $417.43 / $521.73	Professional		$271.30	$417.43	$521.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.06 / $108.20 / $137.65	Professional	26	$66.06	$108.20	$137.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $184.36 / $307.70 / $384.08	Professional	TC	$184.36	$307.70	$384.08