Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $281.84 / $562.34	Facility		$69.18	$281.84	$562.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $17.38 / $22.39	Facility	26	$12.59	$17.38	$22.39
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $38.90 / $275.42 / $407.38	Facility	TC	$38.90	$275.42	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $47.86 / $95.50	Professional		$28.84	$47.86	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $15.49 / $43.65	Professional	26	$9.55	$15.49	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $31.62 / $66.07	Professional	TC	$19.50	$31.62	$66.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $25.70 / $57.54	Professional		$20.89	$25.70	$57.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.22 / $19.05	Professional	26	$7.76	$11.22	$19.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $21.38 / $42.66	Professional	TC	$14.79	$21.38	$42.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $162.18 / $302.00	Facility		$128.82	$162.18	$302.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $60.26 / $63.10	Professional		$56.23	$60.26	$63.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $19.50 / $20.42	Professional	26	$18.62	$19.50	$20.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $41.69 / $48.98	Professional	TC	$38.02	$41.69	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $186.21	Facility		$181.97	$181.97	$186.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $58.88 / $58.88	Facility	26	$58.88	$58.88	$58.88
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	TC	$125.89	$125.89	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $63.10 / $100.00	Professional		$26.30	$63.10	$100.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $21.88 / $29.51	Professional	26	$8.32	$21.88	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $43.65 / $70.79	Professional	TC	$17.78	$43.65	$70.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $302.00 / $389.05	Facility		$64.57	$302.00	$389.05
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 $107.15 / $346.74 / $436.52	Facility	TC	$107.15	$346.74	$436.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $56.23 / $81.28	Professional		$34.67	$56.23	$81.28
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $19.95 / $25.12	Professional	26	$14.13	$19.95	$25.12
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $31.62 / $147.91	Professional	TC	$22.91	$31.62	$147.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $70.79 / $114.82	Professional		$63.10	$70.79	$114.82
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $22.91 / $35.48	Professional	26	$20.42	$22.91	$35.48
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $47.86 / $79.43	Professional	TC	$43.65	$47.86	$79.43
Midlands Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Facility		$181.97	$181.97	$181.97
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $58.88 / $58.88	Facility	26	$58.88	$58.88	$58.88
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	TC	$125.89	$125.89	$125.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $74.13 / $114.82	Professional		$63.10	$74.13	$114.82
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $23.44 / $35.48	Professional	26	$20.42	$23.44	$35.48
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $51.29 / $79.43	Professional	TC	$43.65	$51.29	$79.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $23.99 / $56.23	Professional		$10.47	$23.99	$56.23
United Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $81.28 / $204.17	Facility		$12.02	$81.28	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $75.86	Professional		$32.36	$47.86	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $16.98 / $26.30	Professional	26	$11.22	$16.98	$26.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $29.51 / $48.98	Professional	TC	$20.89	$29.51	$48.98