Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $40.74 / $117.49	Facility	26	$28.18	$40.74	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $45.71 / $213.80	Professional		$37.15	$45.71	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $15.85 / $34.67	Professional	26	$11.48	$15.85	$34.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $28.84 / $69.18	Professional	TC	$25.12	$28.84	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $28.84 / $33.11	Professional		$28.18	$28.84	$33.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $15.14 / $25.70	Professional	26	$10.23	$15.14	$25.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $19.95 / $19.95	Professional	TC	$19.95	$19.95	$19.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $79.43 / $83.18	Professional		$72.44	$79.43	$83.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $25.70 / $26.92	Professional	26	$24.55	$25.70	$26.92
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $53.70 / $56.23	Professional	TC	$48.98	$53.70	$56.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Facility	26	$77.62	$77.62	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $83.18 / $128.82	Professional		$33.88	$83.18	$128.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $26.92 / $39.81	Professional	26	$12.02	$26.92	$39.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $56.23 / $91.20	Professional	TC	$22.91	$56.23	$91.20
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 $44.67 / $66.07 / $281.84	Professional		$44.67	$66.07	$281.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $23.99 / $100.00	Professional	26	$15.85	$23.99	$100.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $41.69 / $251.19	Professional	TC	$30.90	$41.69	$251.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $93.33 / $147.91	Professional		$83.18	$93.33	$147.91
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $30.90 / $46.77	Professional	26	$26.92	$30.90	$46.77
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $63.10 / $102.33	Professional	TC	$56.23	$63.10	$102.33
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Facility	26	$77.62	$77.62	$77.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $83.18 / $147.91	Professional		$72.44	$83.18	$147.91
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $25.70 / $46.77	Professional	26	$21.88	$25.70	$46.77
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $56.23 / $102.33	Professional	TC	$51.29	$56.23	$102.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $30.20 / $72.44	Professional		$13.80	$30.20	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $60.26 / $95.50	Professional		$43.65	$60.26	$95.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $21.88 / $36.31	Professional	26	$14.45	$21.88	$36.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $38.90 / $64.57	Professional	TC	$28.18	$38.90	$64.57