Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $112.20 / $371.54	Facility	26	$69.18	$112.20	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $295.12 / $1,023.29	Professional		$128.82	$295.12	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $60.26 / $177.83	Professional	26	$50.12	$60.26	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $199.53 / $371.54	Professional	TC	$100.00	$199.53	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $138.04 / $323.59	Professional		$117.49	$138.04	$323.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $56.23 / $102.33	Professional	26	$41.69	$56.23	$102.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $107.15 / $208.93	Professional	TC	$60.26	$107.15	$208.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $316.23 / $338.84	Professional		$295.12	$316.23	$338.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $102.33 / $109.65	Professional	26	$97.72	$102.33	$109.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $208.93 / $346.74	Professional	TC	$186.21	$208.93	$346.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $309.03 / $309.03 / $309.03	Facility	26	$309.03	$309.03	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $398.11 / $575.44	Professional		$165.96	$398.11	$575.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $117.49 / $162.18	Professional	26	$53.70	$117.49	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $269.15 / $407.38	Professional	TC	$112.20	$269.15	$407.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $512.86 / $512.86 / $512.86	Facility	26	$512.86	$512.86	$512.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $354.81 / $1,905.46	Professional		$218.78	$354.81	$1,905.46
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $104.71 / $134.90	Professional	26	$72.44	$104.71	$134.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $269.15 / $1,584.89	Professional	TC	$147.91	$269.15	$1,584.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $371.54 / $575.44	Professional		$323.59	$371.54	$575.44
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $120.23 / $186.21	Professional	26	$107.15	$120.23	$186.21
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $251.19 / $389.05	Professional	TC	$218.78	$251.19	$389.05
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $309.03 / $309.03 / $309.03	Facility	26	$309.03	$309.03	$309.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $575.44 / $588.84	Professional		$371.54	$575.44	$588.84
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $120.23 / $186.21	Professional	26	$109.65	$120.23	$186.21
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $389.05 / $467.74	Professional	TC	$251.19	$389.05	$467.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $123.03 / $281.84	Professional		$56.23	$123.03	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $346.74 / $512.86	Professional		$204.17	$346.74	$512.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $107.15 / $151.36	Professional	26	$64.57	$107.15	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $234.42 / $316.23	Professional	TC	$141.25	$234.42	$316.23