Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.40 / $19.36 / $47.00	Facility	26	$14.40	$19.36	$47.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.82 / $75.97 / $264.00	Professional		$62.82	$75.97	$264.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.40 / $30.51 / $67.81	Professional	26	$14.40	$30.51	$67.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.50 / $51.14 / $268.00	Professional	TC	$45.50	$51.14	$268.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.61 / $153.07 / $153.07	Professional		$120.61	$153.07	$153.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.44 / $26.87 / $33.58	Professional	26	$15.44	$26.87	$33.58
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $98.08 / $98.08 / $98.08	Professional	TC	$98.08	$98.08	$98.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.97 / $129.30 / $132.53	Professional		$120.97	$129.30	$132.53
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.53 / $28.35 / $29.80	Professional	26	$26.53	$28.35	$29.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $94.43 / $100.94 / $103.45	Professional	TC	$94.43	$100.94	$103.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.70 / $83.70 / $83.70	Facility	26	$83.70	$83.70	$83.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $149.41 / $206.53	Professional		$68.20	$149.41	$206.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.68 / $33.08 / $42.66	Professional	26	$17.68	$33.08	$42.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.34 / $116.35 / $163.87	Professional	TC	$53.34	$116.35	$163.87
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.00 / $70.00 / $70.00	Facility	26	$70.00	$70.00	$70.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.89 / $122.19 / $453.03	Professional		$74.89	$122.19	$453.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.78 / $29.88 / $95.54	Professional	26	$18.78	$29.88	$95.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $54.51 / $91.67 / $357.49	Professional	TC	$54.51	$91.67	$357.49
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $62.81 / $64.64 / $83.70	Facility	26	$62.81	$64.64	$83.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $119.11 / $143.88 / $185.78	Professional		$119.11	$143.88	$185.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.37 / $62.74 / $119.76	Professional		$15.37	$62.74	$119.76
United Facility/Professional Professional Modifier Low / Median / High Price $75.19 / $122.19 / $153.69	Professional		$75.19	$122.19	$153.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.78 / $30.16 / $38.39	Professional	26	$18.78	$30.16	$38.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.41 / $75.31 / $115.31	Professional	TC	$56.41	$75.31	$115.31