Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $275.42 / $501.19	Facility		$72.44	$275.42	$501.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $15.49 / $19.50	Facility	26	$10.47	$15.49	$19.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.54 / $223.87 / $354.81	Facility	TC	$27.54	$223.87	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $31.62 / $83.18	Professional		$17.78	$31.62	$83.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.77 / $30.20	Professional	26	$7.76	$9.77	$30.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $18.62 / $41.69	Professional	TC	$10.96	$18.62	$41.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $19.95 / $46.77	Professional		$16.60	$19.95	$46.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $8.91 / $15.85	Professional	26	$6.61	$8.91	$15.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $15.49 / $26.30	Professional	TC	$13.18	$15.49	$26.30
BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $173.78 / $302.00	Facility		$134.90	$173.78	$302.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $45.71 / $47.86	Professional		$41.69	$45.71	$47.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $15.85 / $16.98	Professional	26	$14.79	$15.85	$16.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $30.20 / $36.31	Professional	TC	$24.55	$30.20	$36.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $169.82	Facility		$138.04	$138.04	$169.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $46.77 / $46.77	Facility	26	$46.77	$46.77	$46.77
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $93.33 / $93.33 / $93.33	Facility	TC	$93.33	$93.33	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $47.86 / $75.86	Professional		$18.62	$47.86	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $18.62 / $24.55	Professional	26	$7.08	$18.62	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $31.62 / $51.29	Professional	TC	$12.88	$31.62	$51.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $223.87 / $338.84	Facility		$40.74	$223.87	$338.84
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $104.71	Facility	26	$70.79	$70.79	$104.71
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $79.43 / $281.84 / $338.84	Facility	TC	$79.43	$281.84	$338.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $36.31 / $165.96	Professional		$23.44	$36.31	$165.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.85 / $19.95	Professional	26	$10.72	$15.85	$19.95
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $20.89 / $109.65	Professional	TC	$12.30	$20.89	$109.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $54.95 / $89.13	Professional		$47.86	$54.95	$89.13
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $19.05 / $29.51	Professional	26	$16.22	$19.05	$29.51
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $35.48 / $58.88	Professional	TC	$32.36	$35.48	$58.88
Midlands Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $46.77 / $46.77	Facility	26	$46.77	$46.77	$46.77
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $93.33 / $93.33 / $93.33	Facility	TC	$93.33	$93.33	$93.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $57.54 / $89.13	Professional		$47.86	$57.54	$89.13
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $19.50 / $29.51	Professional	26	$16.22	$19.50	$29.51
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $38.02 / $58.88	Professional	TC	$32.36	$38.02	$58.88
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $4,073.80	Facility		$3,467.37	$3,467.37	$4,073.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $18.62 / $43.65	Professional		$8.71	$18.62	$43.65
United Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $81.28 / $204.17	Facility		$10.23	$81.28	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $33.88 / $54.95	Professional		$22.91	$33.88	$54.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $14.13 / $21.88	Professional	26	$9.33	$14.13	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $20.89 / $34.67	Professional	TC	$12.30	$20.89	$34.67