Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.81 / $56.14 / $151.60	Facility	26	$13.81	$56.14	$151.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.09 / $108.11 / $326.00	Professional		$58.09	$108.11	$326.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.75 / $38.76 / $42.73	Professional	26	$13.75	$38.76	$42.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.33 / $50.93 / $251.00	Professional	TC	$44.33	$50.93	$251.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.31 / $44.31 / $134.94	Professional		$44.31	$44.31	$134.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.60 / $19.73 / $32.07	Professional	26	$10.60	$19.73	$32.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.77 / $115.20 / $118.08	Professional		$107.77	$115.20	$118.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.35 / $27.10 / $28.46	Professional	26	$25.35	$27.10	$28.46
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.09 / $88.12 / $90.31	Professional	TC	$79.09	$88.12	$90.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.98 / $79.98 / $79.98	Facility	26	$79.98	$79.98	$79.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.08 / $132.35 / $182.29	Professional		$60.08	$132.35	$182.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.92 / $31.39 / $42.40	Professional	26	$16.92	$31.39	$42.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.56 / $100.76 / $141.57	Professional	TC	$45.56	$100.76	$141.57
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $126.00 / $126.00 / $126.00	Facility	26	$126.00	$126.00	$126.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.37 / $107.86 / $399.42	Professional		$66.37	$107.86	$399.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $28.98 / $137.04	Professional	26	$17.82	$28.98	$137.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $48.54 / $78.88 / $356.00	Professional	TC	$48.54	$78.88	$356.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $57.03 / $58.69 / $79.98	Facility	26	$57.03	$58.69	$79.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $103.62 / $127.45 / $164.85	Professional		$103.62	$127.45	$164.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.05 / $56.18 / $104.99	Professional		$15.05	$56.18	$104.99
United Facility/Professional Professional Modifier Low / Median / High Price $66.37 / $107.86 / $135.68	Professional		$66.37	$107.86	$135.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $28.29 / $36.46	Professional	26	$17.82	$28.29	$36.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.54 / $78.88 / $99.22	Professional	TC	$48.54	$78.88	$99.22