Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.83 / $210.00 / $568.94	Facility	26	$56.83	$210.00	$568.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.98 / $248.27 / $1,310.38	Professional		$190.98	$248.27	$1,310.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.83 / $147.57 / $303.24	Professional	26	$56.83	$147.57	$303.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.15 / $137.84 / $955.86	Professional	TC	$134.15	$137.84	$955.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $156.15 / $156.15 / $156.15	Professional		$156.15	$156.15	$156.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.90 / $78.29 / $132.47	Professional	26	$60.90	$78.29	$132.47
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $109.48 / $109.48 / $248.96	Professional	TC	$109.48	$109.48	$248.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $348.38 / $372.38 / $395.32	Professional		$348.38	$372.38	$395.32
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.13 / $111.30 / $117.64	Professional	26	$104.13	$111.30	$117.64
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $244.25 / $261.07 / $277.69	Professional	TC	$244.25	$261.07	$277.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $328.44 / $328.44 / $328.44	Facility	26	$328.44	$328.44	$328.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $261.75 / $444.20 / $675.89	Professional		$261.75	$444.20	$675.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.22 / $130.69 / $167.75	Professional	26	$83.22	$130.69	$167.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $311.20 / $476.63	Professional	TC	$190.55	$311.20	$476.63
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $553.04 / $553.04 / $553.04	Facility	26	$553.04	$553.04	$553.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $282.31 / $471.34 / $2,319.03	Professional		$282.31	$471.34	$2,319.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $79.34 / $125.31 / $543.21	Professional	26	$79.34	$125.31	$543.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $195.04 / $330.60 / $1,973.17	Professional	TC	$195.04	$330.60	$1,973.17
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $210.09 / $216.21 / $328.44	Facility	26	$210.09	$216.21	$328.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $377.29 / $518.74 / $716.00	Professional		$377.29	$518.74	$716.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $59.93 / $182.83 / $326.35	Professional		$59.93	$182.83	$326.35
United Facility/Professional Professional Modifier Low / Median / High Price $282.31 / $439.42 / $542.90	Professional		$282.31	$439.42	$542.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.34 / $127.67 / $163.19	Professional	26	$79.34	$127.67	$163.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $180.03 / $330.06 / $375.36	Professional	TC	$180.03	$330.06	$375.36