Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.91 / $310.44 / $523.26	Facility	26	$57.91	$310.44	$523.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.68 / $330.93 / $1,179.25	Professional		$179.68	$330.93	$1,179.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.91 / $70.12 / $153.02	Professional	26	$57.91	$70.12	$153.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $121.77 / $121.77 / $820.11	Professional	TC	$121.77	$121.77	$820.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.62 / $79.23 / $134.06	Professional	26	$61.62	$79.23	$134.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $326.98 / $349.50 / $371.94	Professional		$326.98	$349.50	$371.94
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $105.54 / $112.81 / $119.87	Professional	26	$105.54	$112.81	$119.87
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $221.40 / $236.66 / $252.06	Professional	TC	$221.40	$236.66	$252.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $332.94 / $332.94 / $332.94	Facility	26	$332.94	$332.94	$332.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.31 / $416.85 / $633.00	Professional		$229.31	$416.85	$633.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.44 / $132.24 / $169.68	Professional	26	$76.44	$132.24	$169.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $152.87 / $282.27 / $446.58	Professional	TC	$152.87	$282.27	$446.58
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $561.91 / $561.91 / $561.91	Facility	26	$561.91	$561.91	$561.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $247.72 / $419.21 / $2,075.08	Professional		$247.72	$419.21	$2,075.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $76.79 / $122.77 / $460.66	Professional	26	$76.79	$122.77	$460.66
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $167.31 / $283.14 / $1,685.33	Professional	TC	$167.31	$283.14	$1,685.33
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $218.37 / $224.73 / $332.94	Facility	26	$218.37	$224.73	$332.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $354.09 / $446.63 / $633.99	Professional		$354.09	$446.63	$633.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.17 / $171.90 / $306.83	Professional		$60.17	$171.90	$306.83
United Facility/Professional Professional Modifier Low / Median / High Price $228.66 / $419.21 / $501.19	Professional		$228.66	$419.21	$501.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.79 / $120.61 / $150.36	Professional	26	$76.79	$120.61	$150.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $167.31 / $283.14 / $376.93	Professional	TC	$167.31	$283.14	$376.93