Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.09 / $306.77 / $550.88	Facility		$58.09	$306.77	$550.88
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.33 / $32.97 / $94.06	Facility	26	$10.33	$32.97	$94.06
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.59 / $164.22 / $373.44	Facility	TC	$39.59	$164.22	$373.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $60.04 / $161.13	Professional		$36.67	$60.04	$161.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $22.30 / $45.00	Professional	26	$10.02	$22.30	$45.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.06 / $44.32 / $116.00	Professional	TC	$26.06	$44.32	$116.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.17 / $39.75 / $90.91	Professional		$30.17	$39.75	$90.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.36 / $14.82 / $24.07	Professional	26	$10.36	$14.82	$24.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.49 / $20.49 / $53.01	Professional	TC	$20.49	$20.49	$53.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.78 / $198.92 / $373.43	Facility		$146.78	$198.92	$373.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.31 / $73.04 / $74.87	Professional		$68.31	$73.04	$74.87
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.03 / $20.34 / $21.37	Professional	26	$19.03	$20.34	$21.37
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.31 / $52.70 / $54.02	Professional	TC	$47.31	$52.70	$54.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $215.58 / $215.58 / $326.00	Facility		$215.58	$215.58	$326.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.06 / $60.06 / $60.06	Facility	26	$60.06	$60.06	$60.06
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $155.52 / $155.52 / $155.52	Facility	TC	$155.52	$155.52	$155.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $84.11 / $115.39	Professional		$38.61	$84.11	$115.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.42 / $23.72 / $30.06	Professional	26	$12.42	$23.72	$30.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.68 / $60.40 / $85.33	Professional	TC	$27.68	$60.40	$85.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $50.60 / $104.06 / $395.52	Facility		$50.60	$104.06	$395.52
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $53.20 / $100.00 / $100.00	Facility	26	$53.20	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $114.73 / $131.69 / $520.32	Facility	TC	$114.73	$131.69	$520.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.44 / $68.97 / $254.22	Professional		$42.44	$68.97	$254.22
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $21.43 / $90.81	Professional	26	$13.19	$21.43	$90.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.15 / $47.54 / $195.00	Professional	TC	$29.15	$47.54	$195.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $84.11 / $130.15	Facility		$66.00	$84.11	$130.15
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $35.77 / $36.81 / $60.06	Facility	26	$35.77	$36.81	$60.06
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $51.22 / $93.33 / $155.52	Facility	TC	$51.22	$93.33	$155.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $77.27 / $100.09	Professional		$61.00	$77.27	$100.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.74 / $35.47 / $66.63	Professional		$10.74	$35.47	$66.63
United Facility/Professional Facility Modifier Low / Median / High Price $81.70 / $163.63 / $206.53	Facility		$81.70	$163.63	$206.53
United Facility/Professional Professional Modifier Low / Median / High Price $42.44 / $68.97 / $86.76	Professional		$42.44	$68.97	$86.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $21.18 / $26.96	Professional	26	$13.19	$21.18	$26.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.25 / $47.54 / $59.80	Professional	TC	$29.25	$47.54	$59.80