Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $28.18 / $117.49	Facility	26	$16.60	$28.18	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $85.11 / $204.17	Professional		$45.71	$85.11	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $26.92 / $45.71	Professional	26	$12.02	$26.92	$45.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $48.98 / $97.72	Professional	TC	$33.88	$48.98	$97.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $42.66 / $114.82	Professional		$33.88	$42.66	$114.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $17.38 / $25.70	Professional	26	$10.00	$17.38	$25.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $43.65 / $77.62	Professional	TC	$30.20	$43.65	$77.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $95.50 / $102.33	Professional		$89.13	$95.50	$102.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $23.99 / $26.30	Professional	26	$22.91	$23.99	$26.30
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $72.44 / $75.86	Professional	TC	$61.66	$72.44	$75.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Facility	26	$72.44	$72.44	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $100.00 / $162.18	Professional		$41.69	$100.00	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $27.54 / $38.02	Professional	26	$13.80	$27.54	$38.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $75.86 / $123.03	Professional	TC	$30.90	$75.86	$123.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $81.28 / $346.74	Professional		$56.23	$81.28	$346.74
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $25.12 / $44.67	Professional	26	$16.22	$25.12	$44.67
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $53.70 / $257.04	Professional	TC	$38.90	$53.70	$257.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $114.82 / $181.97	Professional		$102.33	$114.82	$181.97
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $28.84 / $44.67	Professional	26	$25.12	$28.84	$44.67
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $85.11 / $138.04	Professional	TC	$75.86	$85.11	$138.04
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Facility	26	$72.44	$72.44	$72.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $91.20 / $181.97	Professional		$87.10	$91.20	$181.97
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $29.51 / $44.67	Professional	26	$25.12	$29.51	$44.67
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $61.66 / $138.04	Professional	TC	$61.66	$61.66	$138.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $43.65 / $93.33	Professional		$13.80	$43.65	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $75.86 / $117.49	Professional		$51.29	$75.86	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $21.38 / $33.88	Professional	26	$14.79	$21.38	$33.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $51.29 / $83.18	Professional	TC	$35.48	$51.29	$83.18