Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.82 / $183.20 / $496.40	Facility	26	$54.82	$183.20	$496.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $209.70 / $392.48 / $703.65	Professional		$209.70	$392.48	$703.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.82 / $138.01 / $398.05	Professional	26	$54.82	$138.01	$398.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $306.33 / $931.29	Professional	TC	$154.88	$306.33	$931.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $156.97 / $156.97 / $156.97	Professional		$156.97	$156.97	$156.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.80 / $96.31 / $126.85	Professional	26	$41.80	$96.31	$126.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $382.58 / $408.94 / $434.07	Professional		$382.58	$408.94	$434.07
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $99.85 / $106.73 / $112.59	Professional	26	$99.85	$106.73	$112.59
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $282.72 / $302.19 / $320.60	Professional	TC	$282.72	$302.19	$320.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $315.00 / $315.00 / $315.00	Facility	26	$315.00	$315.00	$315.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $360.81 / $487.73 / $742.67	Professional		$360.81	$487.73	$742.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.25 / $125.36 / $160.96	Professional	26	$72.25	$125.36	$160.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $266.01 / $360.38 / $643.00	Professional	TC	$266.01	$360.38	$643.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $530.79 / $530.79 / $530.79	Facility	26	$530.79	$530.79	$530.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $342.71 / $571.17 / $2,968.23	Professional		$342.71	$571.17	$2,968.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $68.84 / $116.22 / $505.24	Professional	26	$68.84	$116.22	$505.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $255.20 / $425.33 / $2,638.88	Professional	TC	$255.20	$425.33	$2,638.88
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $185.30 / $190.69 / $315.00	Facility	26	$185.30	$190.69	$315.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $414.33 / $617.38 / $856.15	Professional		$414.33	$617.38	$856.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.54 / $171.78 / $400.29	Professional		$61.54	$171.78	$400.29
United Facility/Professional Professional Modifier Low / Median / High Price $342.71 / $527.65 / $674.51	Professional		$342.71	$527.65	$674.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.84 / $113.76 / $145.85	Professional	26	$68.84	$113.76	$145.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.15 / $374.28 / $548.99	Professional	TC	$204.15	$374.28	$548.99