Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.59 / $219.68 / $610.46	Facility	26	$67.59	$219.68	$610.46
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.24 / $87.18 / $239.66	Facility	53	$38.24	$87.18	$239.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.22 / $245.92 / $1,461.75	Professional		$191.22	$245.92	$1,461.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.87 / $140.00 / $322.00	Professional	26	$64.87	$140.00	$322.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $91.70 / $95.61 / $644.72	Professional	52	$91.70	$95.61	$644.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.63 / $335.00 / $423.50	Professional	TC	$123.63	$335.00	$423.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $152.63 / $201.11 / $437.54	Professional		$152.63	$201.11	$437.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $72.00 / $118.92 / $156.62	Professional	26	$72.00	$118.92	$156.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $129.12 / $129.12 / $230.56	Professional	TC	$129.12	$129.12	$230.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $349.37 / $373.44 / $395.82	Professional		$349.37	$373.44	$395.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.40 / $131.90 / $139.91	Professional	26	$123.40	$131.90	$139.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $225.97 / $241.53 / $255.91	Professional	TC	$225.97	$241.53	$255.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $389.22 / $389.22 / $389.22	Facility	26	$389.22	$389.22	$389.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.19 / $445.45 / $740.75	Professional		$255.19	$445.45	$740.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.10 / $154.47 / $197.80	Professional	26	$89.10	$154.47	$197.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $166.09 / $288.20 / $631.63	Professional	TC	$166.09	$288.20	$631.63
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $656.72 / $656.72 / $656.72	Facility	26	$656.72	$656.72	$656.72
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $285.58 / $285.58 / $285.58	Facility	53	$285.58	$285.58	$285.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $312.89 / $521.50 / $2,872.81	Professional		$312.89	$521.50	$2,872.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $86.71 / $140.91 / $584.49	Professional	26	$86.71	$140.91	$584.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $204.51 / $340.85 / $2,498.98	Professional	TC	$204.51	$340.85	$2,498.98
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $223.67 / $230.19 / $389.22	Facility	26	$223.67	$230.19	$389.22
Midlands Facility/Professional Professional Modifier Low / Median / High Price $378.36 / $488.97 / $886.43	Professional		$378.36	$488.97	$886.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.66 / $184.02 / $328.48	Professional		$70.66	$184.02	$328.48
United Facility/Professional Professional Modifier Low / Median / High Price $312.89 / $481.76 / $592.25	Professional		$312.89	$481.76	$592.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.88 / $141.94 / $180.65	Professional	26	$84.88	$141.94	$180.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.61 / $299.95 / $507.37	Professional	TC	$163.61	$299.95	$507.37