Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $87.10 / $316.23	Facility	26	$51.29	$87.10	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $269.15 / $812.83	Professional		$128.82	$269.15	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $69.18 / $165.96	Professional	26	$38.02	$69.18	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $199.53 / $251.19	Professional	TC	$85.11	$199.53	$251.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $239.88	Professional		$87.10	$102.33	$239.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $41.69 / $77.62	Professional	26	$30.90	$41.69	$77.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $69.18 / $158.49	Professional	TC	$66.07	$69.18	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $239.88 / $257.04	Professional		$229.09	$239.88	$257.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $75.86 / $81.28	Professional	26	$70.79	$75.86	$81.28
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $162.18 / $199.53	Professional	TC	$112.20	$162.18	$199.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	26	$223.87	$223.87	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $309.03 / $426.58	Professional		$117.49	$309.03	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $91.20 / $117.49	Professional	26	$37.15	$91.20	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $208.93 / $323.59	Professional	TC	$79.43	$208.93	$323.59
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $380.19 / $380.19 / $380.19	Facility	26	$380.19	$380.19	$380.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $288.40 / $1,412.54	Professional		$154.88	$288.40	$1,412.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $77.62 / $138.04	Professional	26	$50.12	$77.62	$138.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $194.98 / $1,230.27	Professional	TC	$107.15	$194.98	$1,230.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $281.84 / $436.52	Professional		$251.19	$281.84	$436.52
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $89.13 / $138.04	Professional	26	$77.62	$89.13	$138.04
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $194.98 / $302.00	Professional	TC	$169.82	$194.98	$302.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	26	$223.87	$223.87	$223.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $426.58 / $436.52	Professional		$281.84	$426.58	$436.52
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $93.33 / $138.04	Professional	26	$89.13	$93.33	$138.04
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $302.00 / $338.84	Professional	TC	$194.98	$302.00	$338.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $91.20 / $218.78	Professional		$41.69	$91.20	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $257.04 / $380.19	Professional		$144.54	$257.04	$380.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $77.62 / $107.15	Professional	26	$45.71	$77.62	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $177.83 / $245.47	Professional	TC	$97.72	$177.83	$245.47