Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $51.29 / $51.29	Facility	26	$16.98	$51.29	$51.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $85.11 / $194.98	Professional		$61.66	$85.11	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $16.98 / $43.65	Professional	26	$15.14	$16.98	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $57.54 / $151.36	Professional	TC	$45.71	$57.54	$151.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $147.91	Professional		$54.95	$54.95	$147.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $19.50 / $40.74	Professional	26	$12.88	$19.50	$40.74
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $40.74 / $40.74	Professional	TC	$40.74	$40.74	$40.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $141.25 / $151.36	Professional		$131.83	$141.25	$151.36
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $32.36 / $33.88	Professional	26	$30.90	$32.36	$33.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $109.65 / $117.49	Professional	TC	$102.33	$109.65	$117.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Facility	26	$95.50	$95.50	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $151.36 / $239.88	Professional		$61.66	$151.36	$239.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $36.31 / $50.12	Professional	26	$13.80	$36.31	$50.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $117.49 / $190.55	Professional	TC	$46.77	$117.49	$190.55
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Facility	26	$77.62	$77.62	$77.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $112.20 / $512.86	Professional		$77.62	$112.20	$512.86
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $28.18 / $109.65	Professional	26	$21.38	$28.18	$109.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $83.18 / $398.11	Professional	TC	$58.88	$83.18	$398.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $169.82 / $269.15	Professional		$151.36	$169.82	$269.15
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $38.02 / $57.54	Professional	26	$33.11	$38.02	$57.54
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $128.82 / $213.80	Professional	TC	$117.49	$128.82	$213.80
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Facility	26	$95.50	$95.50	$95.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $177.83 / $269.15	Professional		$151.36	$177.83	$269.15
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $38.90 / $57.54	Professional	26	$33.11	$38.90	$57.54
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $138.04 / $213.80	Professional	TC	$117.49	$138.04	$213.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $64.57 / $138.04	Professional		$17.78	$64.57	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $177.83	Professional		$75.86	$109.65	$177.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $28.18 / $44.67	Professional	26	$18.62	$28.18	$44.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $83.18 / $131.83	Professional	TC	$56.23	$83.18	$131.83