Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $177.83 / $537.03	Facility	26	$125.89	$177.83	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $426.58 / $1,584.89	Professional		$239.88	$426.58	$1,584.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $131.83 / $316.23	Professional	26	$69.18	$131.83	$316.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $288.40 / $489.78	Professional	TC	$169.82	$288.40	$489.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $69.18 / $131.83	Professional	26	$69.18	$69.18	$131.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $467.74 / $501.19	Professional		$436.52	$467.74	$501.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $131.83 / $138.04	Professional	26	$120.23	$131.83	$138.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $331.13 / $707.95	Professional	TC	$309.03	$331.13	$707.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $398.11 / $398.11 / $398.11	Facility	26	$398.11	$398.11	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $588.84 / $912.01	Professional		$257.04	$588.84	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $138.04 / $204.17	Professional	26	$57.54	$138.04	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $416.87 / $812.83	Professional	TC	$190.55	$416.87	$812.83
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 $309.03 / $645.65 / $3,090.30	Professional		$309.03	$645.65	$3,090.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $131.83 / $870.96	Professional	26	$69.18	$131.83	$870.96
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $457.09 / $2,754.23	Professional	TC	$218.78	$457.09	$2,754.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $549.54 / $851.14	Professional		$478.63	$549.54	$851.14
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $158.49 / $239.88	Professional	26	$138.04	$158.49	$239.88
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $398.11 / $616.60	Professional	TC	$338.84	$398.11	$616.60
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $398.11 / $398.11 / $398.11	Facility	26	$398.11	$398.11	$398.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $851.14 / $933.25	Professional		$549.54	$851.14	$933.25
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $117.49 / $239.88	Professional	26	$102.33	$117.49	$239.88
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $616.60 / $831.76	Professional	TC	$398.11	$616.60	$831.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $181.97 / $416.87	Professional		$72.44	$181.97	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $512.86 / $758.58	Professional		$302.00	$512.86	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $114.82 / $181.97	Professional	26	$64.57	$114.82	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $371.54 / $645.65	Professional	TC	$218.78	$371.54	$645.65