Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $186.21 / $549.54	Facility	26	$102.33	$186.21	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $234.42 / $933.25	Professional		$144.54	$234.42	$933.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $114.82 / $177.83	Professional	26	$54.95	$114.82	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $131.83 / $371.54	Professional	TC	$87.10	$131.83	$371.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $67.61 / $123.03	Professional	26	$45.71	$67.61	$123.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $281.84 / $302.00	Professional		$269.15	$281.84	$302.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $112.20 / $120.23	Professional	26	$107.15	$112.20	$120.23
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $165.96 / $223.87	Professional	TC	$112.20	$165.96	$223.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $338.84 / $338.84 / $338.84	Facility	26	$338.84	$338.84	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $363.08 / $457.09	Professional		$138.04	$363.08	$457.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $117.49 / $177.83	Professional	26	$54.95	$117.49	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $213.80 / $309.03	Professional	TC	$83.18	$213.80	$309.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $562.34 / $562.34 / $562.34	Facility	26	$562.34	$562.34	$562.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $309.03 / $1,412.54	Professional		$186.21	$309.03	$1,412.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $114.82 / $389.05	Professional	26	$74.13	$114.82	$389.05
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $204.17 / $1,318.26	Professional	TC	$109.65	$204.17	$1,318.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $338.84 / $512.86	Professional		$295.12	$338.84	$512.86
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $134.90 / $204.17	Professional	26	$117.49	$134.90	$204.17
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $199.53 / $309.03	Professional	TC	$173.78	$199.53	$309.03
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $338.84 / $338.84 / $338.84	Facility	26	$338.84	$338.84	$338.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $436.52 / $512.86	Professional		$338.84	$436.52	$512.86
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $125.89 / $204.17	Professional	26	$104.71	$125.89	$204.17
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $309.03 / $338.84	Professional	TC	$199.53	$309.03	$338.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $128.82 / $257.04	Professional		$61.66	$128.82	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $295.12 / $416.87	Professional		$169.82	$295.12	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $112.20 / $154.88	Professional	26	$66.07	$112.20	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $181.97 / $239.88	Professional	TC	$104.71	$181.97	$239.88