Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $117.49 / $489.78	Facility	26	$91.20	$117.49	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $288.40 / $933.25	Professional		$147.91	$288.40	$933.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $114.82 / $218.78	Professional	26	$51.29	$114.82	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $194.98 / $436.52	Professional	TC	$95.50	$194.98	$436.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $56.23 / $120.23	Professional	26	$41.69	$56.23	$120.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $288.40 / $309.03	Professional		$269.15	$288.40	$309.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $100.00 / $107.15	Professional	26	$93.33	$100.00	$107.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $186.21 / $229.09	Professional	TC	$173.78	$186.21	$229.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $295.12 / $295.12 / $295.12	Facility	26	$295.12	$295.12	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $363.08 / $501.19	Professional		$141.25	$363.08	$501.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $107.15 / $154.88	Professional	26	$48.98	$107.15	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $239.88 / $398.11	Professional	TC	$91.20	$239.88	$398.11
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $501.19 / $501.19 / $501.19	Facility	26	$501.19	$501.19	$501.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $346.74 / $1,698.24	Professional		$186.21	$346.74	$1,698.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $107.15 / $389.05	Professional	26	$66.07	$107.15	$389.05
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $223.87 / $2,041.74	Professional	TC	$123.03	$223.87	$2,041.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $338.84 / $524.81	Professional		$295.12	$338.84	$524.81
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $117.49 / $181.97	Professional	26	$102.33	$117.49	$181.97
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $223.87 / $346.74	Professional	TC	$194.98	$223.87	$346.74
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $295.12 / $295.12 / $295.12	Facility	26	$295.12	$295.12	$295.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $501.19 / $524.81	Professional		$338.84	$501.19	$524.81
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $120.23 / $181.97	Professional	26	$107.15	$120.23	$181.97
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $346.74 / $416.87	Professional	TC	$223.87	$346.74	$416.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $114.82 / $257.04	Professional		$54.95	$114.82	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $309.03 / $426.58	Professional		$173.78	$309.03	$426.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $102.33 / $141.25	Professional	26	$57.54	$102.33	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $204.17 / $302.00	Professional	TC	$112.20	$204.17	$302.00