Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $26.92 / $38.90	Facility	26	$15.49	$26.92	$38.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $47.86 / $208.93	Professional		$35.48	$47.86	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $22.39 / $33.88	Professional	26	$10.96	$22.39	$33.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $32.36 / $134.90	Professional	TC	$23.44	$32.36	$134.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $29.51 / $79.43	Professional		$22.91	$29.51	$79.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $12.88 / $23.99	Professional	26	$12.59	$12.88	$23.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $75.86 / $81.28	Professional		$72.44	$75.86	$81.28
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $23.44 / $25.12	Professional	26	$21.88	$23.44	$25.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $53.70 / $56.23	Professional	TC	$48.98	$53.70	$56.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $69.18 / $69.18	Facility	26	$69.18	$69.18	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $81.28 / $128.82	Professional		$33.11	$81.28	$128.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $26.30 / $35.48	Professional	26	$10.00	$26.30	$35.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $56.23 / $93.33	Professional	TC	$22.91	$56.23	$93.33
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $63.10 / $275.42	Professional		$43.65	$63.10	$275.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $21.88 / $79.43	Professional	26	$15.85	$21.88	$79.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $40.74 / $194.98	Professional	TC	$29.51	$40.74	$194.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $91.20 / $144.54	Professional		$81.28	$91.20	$144.54
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $27.54 / $41.69	Professional	26	$23.99	$27.54	$41.69
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $63.10 / $104.71	Professional	TC	$56.23	$63.10	$104.71
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $69.18 / $69.18	Facility	26	$69.18	$69.18	$69.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $95.50 / $144.54	Professional		$81.28	$95.50	$144.54
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $28.18 / $41.69	Professional	26	$23.99	$28.18	$41.69
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $67.61 / $104.71	Professional	TC	$56.23	$67.61	$104.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $32.36 / $75.86	Professional		$13.49	$32.36	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $60.26 / $95.50	Professional		$40.74	$60.26	$95.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $20.42 / $32.36	Professional	26	$13.80	$20.42	$32.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.90 / $64.57	Professional	TC	$26.92	$38.90	$64.57