Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.21 / $149.79 / $421.15	Facility	26	$49.21	$149.79	$421.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.93 / $236.88 / $701.52	Professional		$123.93	$236.88	$701.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.99 / $56.23 / $177.44	Professional	26	$46.99	$56.23	$177.44
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $64.72 / $64.72 / $456.88	Professional	52	$64.72	$64.72	$456.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $80.22 / $208.96 / $570.79	Professional	TC	$80.22	$208.96	$570.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.47 / $97.47 / $296.88	Professional		$97.47	$97.47	$296.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.53 / $86.93 / $114.50	Professional	26	$38.53	$86.93	$114.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $65.77 / $83.83 / $154.94	Professional	TC	$65.77	$83.83	$154.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $236.50 / $252.80 / $267.92	Professional		$236.50	$252.80	$267.92
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.10 / $96.31 / $98.73	Professional	26	$90.10	$96.31	$98.73
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $146.38 / $156.47 / $166.06	Professional	TC	$146.38	$156.47	$166.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $284.22 / $284.22 / $284.22	Facility	26	$284.22	$284.22	$284.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.46 / $302.08 / $458.50	Professional		$179.46	$302.08	$458.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.50 / $112.81 / $145.44	Professional	26	$67.50	$112.81	$145.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $119.15 / $187.13 / $286.44	Professional	TC	$119.15	$187.13	$286.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $479.84 / $479.84 / $479.84	Facility	26	$479.84	$479.84	$479.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $192.96 / $306.50 / $1,609.32	Professional		$192.96	$306.50	$1,609.32
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $66.73 / $103.34 / $142.07	Professional	26	$66.73	$103.34	$142.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $119.55 / $202.31 / $1,384.00	Professional	TC	$119.55	$202.31	$1,384.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $156.13 / $160.66 / $284.22	Facility	26	$156.13	$160.66	$284.22
Midlands Facility/Professional Professional Modifier Low / Median / High Price $256.14 / $351.59 / $492.00	Professional		$256.14	$351.59	$492.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.56 / $113.03 / $222.79	Professional		$51.56	$113.03	$222.79
United Facility/Professional Professional Modifier Low / Median / High Price $192.96 / $297.27 / $371.08	Professional		$192.96	$297.27	$371.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.73 / $107.40 / $137.28	Professional	26	$66.73	$107.40	$137.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.35 / $187.18 / $243.89	Professional	TC	$110.35	$187.18	$243.89