Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $204.17 / $588.84	Facility	26	$74.13	$204.17	$588.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $309.03 / $1,288.25	Professional		$190.55	$309.03	$1,288.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $134.90 / $245.47	Professional	26	$54.95	$134.90	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $218.78 / $467.74	Professional	TC	$134.90	$218.78	$467.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $158.49	Professional		$147.91	$147.91	$158.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $47.86 / $77.62	Professional	26	$44.67	$47.86	$77.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $251.19 / $302.00	Professional	TC	$102.33	$251.19	$302.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $371.54 / $398.11	Professional		$346.74	$371.54	$398.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $109.65 / $117.49	Professional	26	$104.71	$109.65	$117.49
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $257.04 / $371.54	Professional	TC	$186.21	$257.04	$371.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $331.13 / $331.13 / $331.13	Facility	26	$331.13	$331.13	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $467.74 / $676.08	Professional		$194.98	$467.74	$676.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $123.03 / $169.82	Professional	26	$60.26	$123.03	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $331.13 / $512.86	Professional	TC	$134.90	$331.13	$512.86
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $549.54 / $549.54 / $549.54	Facility	26	$549.54	$549.54	$549.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $446.68 / $2,344.23	Professional		$263.03	$446.68	$2,344.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $117.49 / $537.03	Professional	26	$79.43	$117.49	$537.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $331.13 / $1,995.26	Professional	TC	$181.97	$331.13	$1,995.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $436.52 / $676.08	Professional		$380.19	$436.52	$676.08
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $131.83 / $199.53	Professional	26	$114.82	$131.83	$199.53
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $309.03 / $478.63	Professional	TC	$269.15	$309.03	$478.63
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $331.13 / $331.13 / $331.13	Facility	26	$331.13	$331.13	$331.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $676.08 / $724.44	Professional		$436.52	$676.08	$724.44
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $131.83 / $199.53	Professional	26	$123.03	$131.83	$199.53
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $478.63 / $588.84	Professional	TC	$309.03	$478.63	$588.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $141.25 / $331.13	Professional		$60.26	$141.25	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $407.38 / $562.34	Professional		$239.88	$407.38	$562.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $114.82 / $165.96	Professional	26	$69.18	$114.82	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $288.40 / $389.05	Professional	TC	$169.82	$288.40	$389.05