Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.39 / $251.23 / $536.79	Facility		$41.39	$251.23	$536.79
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.20 / $32.97 / $94.06	Facility	26	$11.20	$32.97	$94.06
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.87 / $136.43 / $399.04	Facility	TC	$27.87	$136.43	$399.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.36 / $61.24 / $140.99	Professional		$30.36	$61.24	$140.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $22.24 / $48.25	Professional	26	$9.19	$22.24	$48.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.01 / $26.19 / $57.26	Professional	TC	$21.01	$26.19	$57.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.60 / $25.96 / $71.90	Professional		$23.60	$25.96	$71.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $16.54 / $21.78	Professional	26	$7.21	$16.54	$21.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $41.12 / $41.12 / $42.56	Professional	TC	$41.12	$41.12	$42.56
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 $56.81 / $60.71 / $62.31	Professional		$56.81	$60.71	$62.31
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.21 / $18.39 / $19.32	Professional	26	$17.21	$18.39	$19.32
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.59 / $42.32 / $43.38	Professional	TC	$39.59	$42.32	$43.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $179.22 / $179.22 / $600.00	Facility		$179.22	$179.22	$600.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.30 / $54.30 / $54.30	Facility	26	$54.30	$54.30	$54.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $124.92 / $124.92 / $124.92	Facility	TC	$124.92	$124.92	$124.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.19 / $70.44 / $95.99	Professional		$32.19	$70.44	$95.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.29 / $21.46 / $27.15	Professional	26	$11.29	$21.46	$27.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.96 / $49.53 / $68.84	Professional	TC	$24.96	$49.53	$68.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.88 / $69.93 / $361.82	Facility		$35.88	$69.93	$361.82
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $105.96 / $105.96 / $513.40	Facility	TC	$105.96	$105.96	$513.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.28 / $58.57 / $218.00	Professional		$35.28	$58.57	$218.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.93 / $19.38 / $87.52	Professional	26	$11.93	$19.38	$87.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.35 / $37.95 / $206.00	Professional	TC	$23.35	$37.95	$206.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $61.53 / $70.44 / $112.07	Facility		$61.53	$70.44	$112.07
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $35.57 / $36.60 / $54.30	Facility	26	$35.57	$36.60	$54.30
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $41.12 / $74.94 / $124.92	Facility	TC	$41.12	$74.94	$124.92
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $69.81 / $86.52	Professional		$61.00	$69.81	$86.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.06 / $30.08 / $55.71	Professional		$10.06	$30.08	$55.71
United Facility/Professional Professional Modifier Low / Median / High Price $35.28 / $58.57 / $73.50	Professional		$35.28	$58.57	$73.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.93 / $19.38 / $24.85	Professional	26	$11.93	$19.38	$24.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.35 / $37.95 / $47.74	Professional	TC	$23.35	$37.95	$47.74