Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.18 / $14.31 / $14.31	Facility	26	$14.18	$14.31	$14.31
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.17 / $29.17 / $31.25	Facility	TC	$29.17	$29.17	$31.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.03 / $43.48 / $249.00	Professional		$38.03	$43.48	$249.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.31 / $14.49 / $90.01	Professional	26	$14.31	$14.49	$90.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.53 / $29.17 / $166.15	Professional	TC	$23.53	$29.17	$166.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.09 / $84.54 / $86.95	Professional		$79.09	$84.54	$86.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.78 / $27.55 / $29.62	Professional	26	$25.78	$27.55	$29.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.57 / $56.97 / $58.39	Professional	TC	$52.57	$56.97	$58.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.30 / $81.30 / $81.30	Facility	26	$81.30	$81.30	$81.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $168.12 / $168.12 / $168.12	Facility	TC	$168.12	$168.12	$168.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $97.48 / $132.84	Professional		$45.71	$97.48	$132.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.57 / $32.88 / $41.69	Professional	26	$17.57	$32.88	$41.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.23 / $66.05 / $91.14	Professional	TC	$29.23	$66.05	$91.14
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.00 / $70.00 / $70.00	Facility	26	$70.00	$70.00	$70.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $140.77 / $140.77 / $140.77	Facility	TC	$140.77	$140.77	$140.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.28 / $81.70 / $297.38	Professional		$50.28	$81.70	$297.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $30.29 / $93.99	Professional	26	$19.05	$30.29	$93.99
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.30 / $50.74 / $203.39	Professional	TC	$30.30	$50.74	$203.39
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $52.87 / $54.41 / $81.30	Facility	26	$52.87	$54.41	$81.30
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $54.78 / $85.12 / $168.12	Facility	TC	$54.78	$85.12	$168.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $81.03 / $97.48 / $121.13	Professional		$81.03	$97.48	$121.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.05 / $41.04 / $76.20	Professional		$15.05	$41.04	$76.20
United Facility/Professional Professional Modifier Low / Median / High Price $50.28 / $83.29 / $102.78	Professional		$50.28	$83.29	$102.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $30.34 / $38.95	Professional	26	$19.05	$30.34	$38.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.22 / $50.74 / $64.31	Professional	TC	$31.22	$50.74	$64.31