Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.30 / $329.22 / $645.84	Facility		$83.30	$329.22	$645.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.02 / $16.53 / $21.04	Facility	26	$10.02	$16.53	$21.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.80 / $268.70 / $455.00	Facility	TC	$31.80	$268.70	$455.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.46 / $48.36 / $109.60	Professional		$31.46	$48.36	$109.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.71 / $19.97 / $44.00	Professional	26	$9.71	$19.97	$44.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.26 / $78.70	Professional	TC	$19.95	$30.26	$78.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.63 / $57.89 / $73.45	Professional		$25.63	$57.89	$73.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.13 / $18.70 / $23.37	Professional	26	$9.13	$18.70	$23.37
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.45 / $16.45 / $42.56	Professional	TC	$16.45	$16.45	$42.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.13 / $198.00 / $302.62	Facility		$146.13	$198.00	$302.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.06 / $62.06 / $63.60	Professional		$58.06	$62.06	$63.60
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.46 / $19.73 / $20.53	Professional	26	$18.46	$19.73	$20.53
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.59 / $42.32 / $43.38	Professional	TC	$39.59	$42.32	$43.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $183.12 / $183.12 / $185.00	Facility		$183.12	$183.12	$185.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.26 / $58.26 / $58.26	Facility	26	$58.26	$58.26	$58.26
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $124.92 / $124.92 / $124.92	Facility	TC	$124.92	$124.92	$124.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.34 / $71.38 / $97.93	Professional		$33.34	$71.38	$97.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.04 / $23.02 / $29.09	Professional	26	$12.04	$23.02	$29.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.63 / $48.35 / $68.84	Professional	TC	$22.63	$48.35	$68.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.17 / $276.80 / $390.08	Facility		$53.17	$276.80	$390.08
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 $105.96 / $350.61 / $436.80	Facility	TC	$105.96	$350.61	$436.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.54 / $59.38 / $215.20	Professional		$36.54	$59.38	$215.20
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.24 / $20.00 / $26.15	Professional	26	$13.24	$20.00	$26.15
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.07 / $38.59 / $149.15	Professional	TC	$23.07	$38.59	$149.15
Midlands Facility/Professional Facility Modifier Low / Median / High Price $41.60 / $70.22 / $111.75	Facility		$41.60	$70.22	$111.75
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $35.63 / $36.67 / $58.26	Facility	26	$35.63	$36.67	$58.26
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $41.12 / $65.03 / $124.92	Facility	TC	$41.12	$65.03	$124.92
Midlands Facility/Professional Professional Modifier Low / Median / High Price $58.84 / $71.38 / $89.26	Professional		$58.84	$71.38	$89.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.40 / $31.13 / $55.57	Professional		$10.40	$31.13	$55.57
United Facility/Professional Professional Modifier Low / Median / High Price $36.54 / $58.68 / $74.69	Professional		$36.54	$58.68	$74.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.79 / $19.98 / $26.15	Professional	26	$12.79	$19.98	$26.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.84 / $35.88 / $48.54	Professional	TC	$22.84	$35.88	$48.54