Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.70 / $255.71 / $720.88	Facility	26	$79.70	$255.71	$720.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $243.65 / $347.14 / $1,547.26	Professional		$243.65	$347.14	$1,547.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.73 / $88.86 / $324.72	Professional	26	$75.73	$88.86	$324.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.94 / $250.93 / $1,053.10	Professional	TC	$163.94	$250.93	$1,053.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.75 / $114.12 / $185.38	Professional	26	$79.75	$114.12	$185.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.84 / $162.84 / $162.84	Professional	TC	$162.84	$162.84	$162.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $449.95 / $480.95 / $504.36	Professional		$449.95	$480.95	$504.36
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $145.53 / $155.56 / $165.00	Professional	26	$145.53	$155.56	$165.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $304.41 / $325.38 / $339.36	Professional	TC	$304.41	$325.38	$339.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $459.06 / $459.06 / $459.06	Facility	26	$459.06	$459.06	$459.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $330.85 / $593.20 / $902.31	Professional		$330.85	$593.20	$902.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.21 / $182.10 / $234.65	Professional	26	$105.21	$182.10	$234.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $227.53 / $407.10 / $623.79	Professional	TC	$227.53	$407.10	$623.79
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $773.84 / $773.84 / $773.84	Facility	26	$773.84	$773.84	$773.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $359.89 / $609.04 / $3,248.56	Professional		$359.89	$609.04	$3,248.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $101.54 / $165.72 / $487.07	Professional	26	$101.54	$165.72	$487.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $249.32 / $421.94 / $2,762.21	Professional	TC	$249.32	$421.94	$2,762.21
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $272.88 / $280.83 / $459.06	Facility	26	$272.88	$280.83	$459.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $487.29 / $617.29 / $902.31	Professional		$487.29	$617.29	$902.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.07 / $202.02 / $459.55	Professional		$83.07	$202.02	$459.55
United Facility/Professional Professional Modifier Low / Median / High Price $332.21 / $567.23 / $692.10	Professional		$332.21	$567.23	$692.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.06 / $165.85 / $206.76	Professional	26	$102.06	$165.85	$206.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $249.32 / $414.21 / $575.25	Professional	TC	$249.32	$414.21	$575.25