Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.37 / $340.25 / $945.52	Facility	26	$104.37	$340.25	$945.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $311.41 / $412.32 / $1,972.45	Professional		$311.41	$412.32	$1,972.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.67 / $225.07 / $513.24	Professional	26	$99.67	$225.07	$513.24
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $155.71 / $155.71 / $1,056.52	Professional	52	$155.71	$155.71	$1,056.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $207.04 / $335.00 / $1,464.67	Professional	TC	$207.04	$335.00	$1,464.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $232.79 / $247.34 / $709.03	Professional		$232.79	$247.34	$709.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $95.58 / $188.75 / $242.86	Professional	26	$95.58	$188.75	$242.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $153.05 / $153.05 / $382.64	Professional	TC	$153.05	$153.05	$382.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $566.98 / $606.03 / $644.62	Professional		$566.98	$606.03	$644.62
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $190.59 / $203.72 / $216.05	Professional	26	$190.59	$203.72	$216.05
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $376.38 / $402.31 / $428.56	Professional	TC	$376.38	$402.31	$428.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $601.20 / $601.20 / $601.20	Facility	26	$601.20	$601.20	$601.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $417.42 / $722.10 / $1,099.28	Professional		$417.42	$722.10	$1,099.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $137.34 / $238.76 / $307.37	Professional	26	$137.34	$238.76	$307.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $280.08 / $478.89 / $864.86	Professional	TC	$280.08	$478.89	$864.86
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,013.76 / $1,013.76 / $1,013.76	Facility	26	$1,013.76	$1,013.76	$1,013.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $512.21 / $830.11 / $6,146.58	Professional		$512.21	$830.11	$6,146.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $135.58 / $215.79 / $320.47	Professional	26	$135.58	$215.79	$320.47
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $344.76 / $574.60 / $5,551.18	Professional	TC	$344.76	$574.60	$5,551.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $360.60 / $371.11 / $601.20	Facility	26	$360.60	$371.11	$601.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $614.02 / $784.34 / $1,459.73	Professional		$614.02	$784.34	$1,459.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $110.21 / $298.89 / $533.52	Professional		$110.21	$298.89	$533.52
United Facility/Professional Professional Modifier Low / Median / High Price $512.21 / $751.23 / $1,054.30	Professional		$512.21	$751.23	$1,054.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $133.96 / $219.18 / $279.08	Professional	26	$133.96	$219.18	$279.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.80 / $506.70 / $739.53	Professional	TC	$275.80	$506.70	$739.53