Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $169.82 / $660.69	Facility	26	$104.71	$169.82	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $426.58 / $1,513.56	Professional		$245.47	$426.58	$1,513.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $95.50 / $208.93	Professional	26	$75.86	$95.50	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $309.03 / $457.09	Professional	TC	$162.18	$309.03	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $229.09 / $288.40	Professional		$218.78	$229.09	$288.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $91.20 / $165.96	Professional	26	$63.10	$91.20	$165.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $478.63 / $501.19	Professional		$446.68	$478.63	$501.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $154.88 / $165.96	Professional	26	$144.54	$154.88	$165.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $316.23 / $371.54	Professional	TC	$186.21	$316.23	$371.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $457.09 / $457.09 / $457.09	Facility	26	$457.09	$457.09	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $602.56 / $912.01	Professional		$245.47	$602.56	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $158.49 / $239.88	Professional	26	$75.86	$158.49	$239.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $407.38 / $724.44	Professional	TC	$169.82	$407.38	$724.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $776.25 / $776.25 / $776.25	Facility	26	$776.25	$776.25	$776.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $602.56 / $3,235.94	Professional		$331.13	$602.56	$3,235.94
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $154.88 / $213.80	Professional	26	$102.33	$154.88	$213.80
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $426.58 / $2,754.23	Professional	TC	$229.09	$426.58	$2,754.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $562.34 / $912.01	Professional		$489.78	$562.34	$912.01
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $181.97 / $275.42	Professional	26	$158.49	$181.97	$275.42
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $389.05 / $630.96	Professional	TC	$331.13	$389.05	$630.96
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $457.09 / $457.09 / $457.09	Facility	26	$457.09	$457.09	$457.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $660.69 / $912.01	Professional		$549.54	$660.69	$912.01
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $162.18 / $275.42	Professional	26	$128.82	$162.18	$275.42
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $537.03 / $724.44	Professional	TC	$371.54	$537.03	$724.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $199.53 / $467.74	Professional		$83.18	$199.53	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $549.54 / $741.31	Professional		$302.00	$549.54	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $151.36 / $208.93	Professional	26	$89.13	$151.36	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $398.11 / $588.84	Professional	TC	$213.80	$398.11	$588.84