Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.03 / $290.70 / $515.73	Facility		$46.03	$290.70	$515.73
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.36 / $12.89 / $17.55	Facility	26	$8.36	$12.89	$17.55
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.24 / $277.14 / $352.51	Facility	TC	$25.24	$277.14	$352.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.14 / $38.44 / $109.00	Professional		$19.14	$38.44	$109.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.97 / $11.67 / $38.18	Professional	26	$7.97	$11.67	$38.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.72 / $21.05 / $47.70	Professional	TC	$11.72	$21.05	$47.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.57 / $18.57 / $46.44	Professional		$18.57	$18.57	$46.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.63 / $13.82 / $19.48	Professional	26	$6.63	$13.82	$19.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.78 / $193.05 / $373.43	Facility		$146.78	$193.05	$373.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.35 / $47.18 / $48.35	Professional		$42.35	$47.18	$48.35
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.82 / $15.84 / $17.12	Professional	26	$14.82	$15.84	$17.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.14 / $31.34 / $32.11	Professional	TC	$28.14	$31.34	$32.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.26 / $139.26 / $168.00	Facility		$139.26	$139.26	$168.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.80 / $46.80 / $46.80	Facility	26	$46.80	$46.80	$46.80
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $92.46 / $92.46 / $92.46	Facility	TC	$92.46	$92.46	$92.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.12 / $55.08 / $74.66	Professional		$26.12	$55.08	$74.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.16 / $19.19 / $24.24	Professional	26	$10.16	$19.19	$24.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.17 / $35.59 / $50.42	Professional	TC	$16.17	$35.59	$50.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.35 / $177.84 / $332.92	Facility		$36.35	$177.84	$332.92
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.00 / $70.00 / $104.50	Facility	26	$70.00	$70.00	$104.50
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $78.72 / $277.55 / $340.80	Facility	TC	$78.72	$277.55	$340.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.01 / $46.32 / $165.42	Professional		$24.01	$46.32	$165.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.67 / $16.50 / $21.81	Professional	26	$10.67	$16.50	$21.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $12.46 / $27.57 / $110.07	Professional	TC	$12.46	$27.57	$110.07
Midlands Facility/Professional Facility Modifier Low / Median / High Price $30.79 / $54.78 / $72.79	Facility		$30.79	$54.78	$72.79
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $29.88 / $30.75 / $46.80	Facility	26	$29.88	$30.75	$46.80
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $30.46 / $35.47 / $92.46	Facility	TC	$30.46	$35.47	$92.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $38.75 / $55.08 / $68.30	Professional		$38.75	$55.08	$68.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.74 / $24.20 / $43.20	Professional		$8.74	$24.20	$43.20
United Facility/Professional Facility Modifier Low / Median / High Price $81.70 / $163.63 / $206.53	Facility		$81.70	$163.63	$206.53
United Facility/Professional Professional Modifier Low / Median / High Price $24.01 / $38.00 / $58.26	Professional		$24.01	$38.00	$58.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.67 / $17.13 / $22.08	Professional	26	$10.67	$17.13	$22.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.25 / $28.98 / $36.45	Professional	TC	$17.25	$28.98	$36.45