Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.38 / $361.12 / $607.42	Facility		$50.38	$361.12	$607.42
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.33 / $23.53 / $85.32	Facility	26	$10.33	$23.53	$85.32
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.15 / $323.91 / $520.70	Facility	TC	$39.15	$323.91	$520.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $68.92 / $159.00	Professional		$36.65	$68.92	$159.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.03 / $20.30 / $44.00	Professional	26	$10.03	$20.30	$44.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.22 / $32.61 / $63.49	Professional	TC	$26.22	$32.61	$63.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.73 / $39.75 / $86.47	Professional		$29.73	$39.75	$86.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.36 / $19.27 / $24.07	Professional	26	$10.36	$19.27	$24.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.49 / $20.49 / $53.01	Professional	TC	$20.49	$20.49	$53.01
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 $68.90 / $73.65 / $75.50	Professional		$68.90	$73.65	$75.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.03 / $20.34 / $21.37	Professional	26	$19.03	$20.34	$21.37
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.88 / $53.32 / $54.64	Professional	TC	$48.88	$53.32	$54.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $217.38 / $217.38 / $600.00	Facility		$217.38	$217.38	$600.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.06 / $60.06 / $60.06	Facility	26	$60.06	$60.06	$60.06
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $157.32 / $157.32 / $157.32	Facility	TC	$157.32	$157.32	$157.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $84.68 / $115.39	Professional		$38.61	$84.68	$115.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.42 / $23.72 / $30.06	Professional	26	$12.42	$23.72	$30.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.68 / $61.11 / $85.33	Professional	TC	$27.68	$61.11	$85.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $56.01 / $206.26 / $506.18	Facility		$56.01	$206.26	$506.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $53.20 / $100.00 / $100.00	Facility	26	$53.20	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $131.69 / $324.57 / $703.68	Facility	TC	$131.69	$324.57	$703.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.44 / $68.97 / $256.38	Professional		$42.44	$68.97	$256.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $20.95 / $32.28	Professional	26	$13.19	$20.95	$32.28
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.25 / $47.66 / $211.00	Professional	TC	$29.25	$47.66	$211.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $84.68 / $129.56	Facility		$70.00	$84.68	$129.56
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $37.36 / $38.45 / $60.06	Facility	26	$37.36	$38.45	$60.06
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $51.22 / $84.10 / $157.32	Facility	TC	$51.22	$84.10	$157.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $62.40 / $77.92 / $100.00	Professional		$62.40	$77.92	$100.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.80 / $35.47 / $67.72	Professional		$10.80	$35.47	$67.72
United Facility/Professional Professional Modifier Low / Median / High Price $42.44 / $68.97 / $86.76	Professional		$42.44	$68.97	$86.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $21.18 / $26.96	Professional	26	$13.19	$21.18	$26.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.25 / $47.54 / $59.80	Professional	TC	$29.25	$47.54	$59.80