Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $263.03 / $776.25	Facility	26	$128.82	$263.03	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $478.63 / $1,202.26	Professional		$323.59	$478.63	$1,202.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $141.25 / $323.59	Professional	26	$67.61	$141.25	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $338.84 / $977.24	Professional	TC	$251.19	$338.84	$977.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Professional		$245.47	$245.47	$245.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $128.82 / $162.18	Professional	26	$52.48	$128.82	$162.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $616.60 / $660.69	Professional		$588.84	$616.60	$660.69
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $131.83 / $138.04	Professional	26	$123.03	$131.83	$138.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $478.63 / $776.25	Professional	TC	$389.05	$478.63	$776.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $389.05 / $389.05 / $389.05	Facility	26	$389.05	$389.05	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $794.33 / $1,318.26	Professional		$338.84	$794.33	$1,318.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $151.36 / $204.17	Professional	26	$64.57	$151.36	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $616.60 / $1,174.90	Professional	TC	$275.42	$616.60	$1,174.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $660.69 / $660.69 / $660.69	Facility	26	$660.69	$660.69	$660.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $870.96 / $5,370.32	Professional		$416.87	$870.96	$5,370.32
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $141.25 / $812.83	Professional	26	$87.10	$141.25	$812.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $676.08 / $4,897.79	Professional	TC	$331.13	$676.08	$4,897.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $741.31 / $1,148.15	Professional		$645.65	$741.31	$1,148.15
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $154.88 / $234.42	Professional	26	$134.90	$154.88	$234.42
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $575.44 / $891.25	Professional	TC	$501.19	$575.44	$891.25
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $389.05 / $389.05 / $389.05	Facility	26	$389.05	$389.05	$389.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,148.15 / $1,659.59	Professional		$741.31	$1,148.15	$1,659.59
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $165.96 / $234.42	Professional	26	$154.88	$165.96	$234.42
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $575.44 / $891.25 / $1,479.11	Professional	TC	$575.44	$891.25	$1,479.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $269.15 / $575.44	Professional		$70.79	$269.15	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $707.95 / $1,412.54	Professional		$407.38	$707.95	$1,412.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $134.90 / $186.21	Professional	26	$77.62	$134.90	$186.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $562.34 / $933.25	Professional	TC	$323.59	$562.34	$933.25