Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.21 / $66.18 / $93.49	Facility	26	$49.21	$66.18	$93.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.77 / $170.54 / $492.00	Professional		$133.77	$170.54	$492.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.21 / $96.00 / $152.80	Professional	26	$49.21	$96.00	$152.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.55 / $97.45 / $275.89	Professional	TC	$84.55	$97.45	$275.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.64 / $106.93 / $306.50	Professional		$100.64	$106.93	$306.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.88 / $93.98 / $121.93	Professional	26	$37.88	$93.98	$121.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $88.26 / $88.26 / $163.12	Professional	TC	$88.26	$88.26	$163.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $244.12 / $260.94 / $267.45	Professional		$244.12	$260.94	$267.45
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 $154.00 / $164.62 / $168.74	Professional	TC	$154.00	$164.62	$168.74
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 $173.13 / $305.67 / $409.18	Professional		$173.13	$305.67	$409.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.19 / $111.31 / $145.44	Professional	26	$64.19	$111.31	$145.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.94 / $192.86 / $263.74	Professional	TC	$108.94	$192.86	$263.74
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 $170.74 / $284.44 / $915.52	Professional		$170.74	$284.44	$915.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $62.33 / $101.28 / $149.21	Professional	26	$62.33	$101.28	$149.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $112.71 / $183.16 / $591.79	Professional	TC	$112.71	$183.16	$591.79
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $59.00 / $59.00 / $284.22	Facility	26	$59.00	$59.00	$284.22
Midlands Facility/Professional Professional Modifier Low / Median / High Price $264.38 / $306.49 / $474.36	Professional		$264.38	$306.49	$474.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.92 / $96.37 / $230.69	Professional		$50.92	$96.37	$230.69
United Facility/Professional Professional Modifier Low / Median / High Price $175.04 / $281.08 / $354.61	Professional		$175.04	$281.08	$354.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.33 / $100.09 / $129.85	Professional	26	$62.33	$100.09	$129.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.71 / $191.20 / $228.34	Professional	TC	$112.71	$191.20	$228.34