Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $213.80 / $630.96	Facility	26	$158.49	$213.80	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $338.84 / $1,380.38	Professional		$213.80	$338.84	$1,380.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $134.90 / $194.98	Professional	26	$66.07	$134.90	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $223.87 / $371.54	Professional	TC	$141.25	$223.87	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $489.78	Professional		$169.82	$169.82	$489.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $79.43 / $177.83	Professional	26	$57.54	$79.43	$177.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $416.87 / $446.68	Professional		$389.05	$416.87	$446.68
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $141.25 / $147.91	Professional	26	$134.90	$141.25	$147.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $269.15 / $371.54	Professional	TC	$186.21	$269.15	$371.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $426.58 / $426.58 / $426.58	Facility	26	$426.58	$426.58	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $524.81 / $676.08	Professional		$204.17	$524.81	$676.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $144.54 / $218.78	Professional	26	$63.10	$144.54	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $346.74 / $478.63	Professional	TC	$134.90	$346.74	$478.63
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Facility	26	$707.95	$707.95	$707.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $457.09 / $2,041.74	Professional		$275.42	$457.09	$2,041.74
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $141.25 / $489.78	Professional	26	$83.18	$141.25	$489.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $331.13 / $1,995.26	Professional	TC	$181.97	$331.13	$1,995.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $501.19 / $758.58	Professional		$426.58	$501.19	$758.58
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $169.82 / $257.04	Professional	26	$147.91	$169.82	$257.04
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $331.13 / $501.19	Professional	TC	$281.84	$331.13	$501.19
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $426.58 / $426.58 / $426.58	Facility	26	$426.58	$426.58	$426.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $616.60 / $758.58	Professional		$501.19	$616.60	$758.58
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $141.25 / $257.04	Professional	26	$117.49	$141.25	$257.04
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $478.63 / $512.86	Professional	TC	$331.13	$478.63	$512.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $162.18 / $371.54	Professional		$75.86	$162.18	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $426.58 / $602.56	Professional		$251.19	$426.58	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $131.83 / $181.97	Professional	26	$79.43	$131.83	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $302.00 / $389.05	Professional	TC	$173.78	$302.00	$389.05