Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.56 / $105.20 / $382.96	Facility		$41.56	$105.20	$382.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.33 / $33.45 / $92.96	Facility	26	$10.33	$33.45	$92.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.12 / $34.54 / $129.74	Professional		$23.12	$34.54	$129.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $23.12 / $27.12	Professional	26	$9.86	$23.12	$27.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.41 / $39.10 / $53.37	Professional	TC	$22.41	$39.10	$53.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.26 / $65.64 / $79.97	Professional		$26.26	$65.64	$79.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $14.30 / $24.07	Professional	26	$11.07	$14.30	$24.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.78 / $198.92 / $373.43	Facility		$146.78	$198.92	$373.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.20 / $67.56 / $69.25	Professional		$63.20	$67.56	$69.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.46 / $19.73 / $21.37	Professional	26	$18.46	$19.73	$21.37
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.32 / $47.82 / $49.02	Professional	TC	$44.32	$47.82	$49.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.38 / $199.38 / $326.00	Facility		$199.38	$199.38	$326.00
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 Professional Modifier Low / Median / High Price $36.15 / $78.28 / $106.66	Professional		$36.15	$78.28	$106.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.42 / $23.72 / $30.06	Professional	26	$12.42	$23.72	$30.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.35 / $54.73 / $76.59	Professional	TC	$25.35	$54.73	$76.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.54 / $64.19 / $334.50	Facility		$34.54	$64.19	$334.50
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.68 / $64.48 / $236.90	Professional		$39.68	$64.48	$236.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $21.43 / $82.56	Professional	26	$13.19	$21.43	$82.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.49 / $43.06 / $190.00	Professional	TC	$26.49	$43.06	$190.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $63.14 / $78.28 / $121.03	Facility		$63.14	$78.28	$121.03
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $33.99 / $34.97 / $58.26	Facility	26	$33.99	$34.97	$58.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $71.48 / $97.46	Professional		$57.00	$71.48	$97.46
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.45 / $26.66 / $60.35	Professional		$10.45	$26.66	$60.35
United Facility/Professional Professional Modifier Low / Median / High Price $36.33 / $65.92 / $81.12	Professional		$36.33	$65.92	$81.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $20.61 / $26.96	Professional	26	$13.19	$20.61	$26.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.49 / $44.97 / $55.20	Professional	TC	$26.49	$44.97	$55.20