Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $177.83 / $676.08	Facility	26	$102.33	$177.83	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $389.05 / $1,202.26	Professional		$245.47	$389.05	$1,202.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $97.72 / $245.47	Professional	26	$79.43	$97.72	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $323.59 / $512.86	Professional	TC	$162.18	$323.59	$512.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $213.80 / $588.84	Professional		$199.53	$213.80	$588.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $95.50 / $165.96	Professional	26	$66.07	$95.50	$165.96
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $199.53 / $323.59	Professional	TC	$158.49	$199.53	$323.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $478.63 / $512.86	Professional		$457.09	$478.63	$512.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $158.49 / $169.82	Professional	26	$151.36	$158.49	$169.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $316.23 / $371.54	Professional	TC	$186.21	$316.23	$371.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $478.63 / $478.63 / $478.63	Facility	26	$478.63	$478.63	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $616.60 / $851.14	Professional		$251.19	$616.60	$851.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $165.96 / $251.19	Professional	26	$79.43	$165.96	$251.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $407.38 / $630.96	Professional	TC	$173.78	$407.38	$630.96
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $812.83 / $812.83 / $812.83	Facility	26	$812.83	$812.83	$812.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $575.44 / $3,162.28	Professional		$338.84	$575.44	$3,162.28
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $162.18 / $213.80	Professional	26	$107.15	$162.18	$213.80
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $426.58 / $2,691.53	Professional	TC	$234.42	$426.58	$2,691.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $575.44 / $912.01	Professional		$501.19	$575.44	$912.01
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $190.55 / $288.40	Professional	26	$165.96	$190.55	$288.40
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $389.05 / $630.96	Professional	TC	$331.13	$389.05	$630.96
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $478.63 / $478.63 / $478.63	Facility	26	$478.63	$478.63	$478.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $776.25 / $933.25	Professional		$562.34	$776.25	$933.25
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $181.97 / $288.40	Professional	26	$144.54	$181.97	$288.40
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $630.96 / $724.44	Professional	TC	$371.54	$630.96	$724.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $204.17 / $478.63	Professional		$87.10	$204.17	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $549.54 / $741.31	Professional		$309.03	$549.54	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $158.49 / $223.87	Professional	26	$93.33	$158.49	$223.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $398.11 / $501.19	Professional	TC	$213.80	$398.11	$501.19