Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.81 / $203.19 / $571.73	Facility	26	$75.81	$203.19	$571.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.69 / $335.00 / $1,172.06	Professional		$179.69	$335.00	$1,172.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.95 / $136.32 / $294.67	Professional	26	$62.95	$136.32	$294.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $111.60 / $180.39 / $760.02	Professional	TC	$111.60	$180.39	$760.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.58 / $134.58 / $409.88	Professional		$134.58	$134.58	$409.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.27 / $120.12 / $156.04	Professional	26	$67.27	$120.12	$156.04
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $121.15 / $121.15 / $216.34	Professional	TC	$121.15	$121.15	$216.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $327.52 / $350.10 / $371.95	Professional		$327.52	$350.10	$371.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $115.26 / $123.20 / $130.78	Professional	26	$115.26	$123.20	$130.78
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $212.28 / $226.90 / $241.18	Professional	TC	$212.28	$226.90	$241.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $363.60 / $363.60 / $363.60	Facility	26	$363.60	$363.60	$363.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.70 / $417.33 / $546.87	Professional		$228.70	$417.33	$546.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.50 / $144.37 / $185.20	Professional	26	$82.50	$144.37	$185.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $153.69 / $270.43 / $409.00	Professional	TC	$153.69	$270.43	$409.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $612.88 / $612.88 / $612.88	Facility	26	$612.88	$612.88	$612.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $246.91 / $396.22 / $1,680.90	Professional		$246.91	$396.22	$1,680.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $79.34 / $131.55 / $414.94	Professional	26	$79.34	$131.55	$414.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $159.21 / $269.43 / $1,425.00	Professional	TC	$159.21	$269.43	$1,425.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $211.96 / $218.14 / $363.60	Facility	26	$211.96	$218.14	$363.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $354.71 / $452.32 / $619.09	Professional		$354.71	$452.32	$619.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $65.41 / $172.19 / $307.36	Professional		$65.41	$172.19	$307.36
United Facility/Professional Professional Modifier Low / Median / High Price $246.91 / $380.94 / $474.83	Professional		$246.91	$380.94	$474.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.95 / $131.55 / $164.00	Professional	26	$80.95	$131.55	$164.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $148.99 / $249.27 / $306.18	Professional	TC	$148.99	$249.27	$306.18