Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $42.66 / $60.26	Facility	26	$41.69	$42.66	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $162.18 / $245.47	Professional		$74.13	$162.18	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $28.84 / $46.77	Professional	26	$16.98	$28.84	$46.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $72.44 / $177.83	Professional	TC	$53.70	$72.44	$177.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $190.55	Professional		$97.72	$97.72	$190.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $15.14 / $15.14	Professional	26	$15.14	$15.14	$15.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $177.83 / $186.21	Professional		$162.18	$177.83	$186.21
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $37.15 / $38.90	Professional	26	$34.67	$37.15	$38.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $141.25 / $147.91	Professional	TC	$109.65	$141.25	$147.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $186.21 / $295.12	Professional		$74.13	$186.21	$295.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $42.66 / $58.88	Professional	26	$16.22	$42.66	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $144.54 / $234.42	Professional	TC	$56.23	$144.54	$234.42
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $91.20 / $91.20	Facility	26	$91.20	$91.20	$91.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $134.90 / $630.96	Professional		$91.20	$134.90	$630.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $32.36 / $128.82	Professional	26	$24.55	$32.36	$128.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $100.00 / $512.86	Professional	TC	$70.79	$100.00	$512.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $208.93 / $331.13	Professional		$186.21	$208.93	$331.13
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $44.67 / $67.61	Professional	26	$38.02	$44.67	$67.61
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $165.96 / $263.03	Professional	TC	$147.91	$165.96	$263.03
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $218.78 / $331.13	Professional		$186.21	$218.78	$331.13
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $45.71 / $67.61	Professional	26	$38.02	$45.71	$67.61
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $173.78 / $263.03	Professional	TC	$147.91	$173.78	$263.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $81.28 / $173.78	Professional		$20.42	$81.28	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $128.82 / $213.80	Professional		$89.13	$128.82	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $31.62 / $50.12	Professional	26	$21.38	$31.62	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $100.00 / $162.18	Professional	TC	$67.61	$100.00	$162.18