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 / $117.49	Facility	26	$15.49	$26.92	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $57.54 / $134.90	Professional		$42.66	$57.54	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $24.55 / $53.70	Professional	26	$11.75	$24.55	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $46.77 / $89.13	Professional	TC	$33.88	$46.77	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $39.81 / $102.33	Professional		$33.11	$39.81	$102.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $14.13 / $24.55	Professional	26	$9.33	$14.13	$24.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $45.71 / $72.44	Professional	TC	$26.92	$45.71	$72.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $93.33 / $97.72	Professional		$89.13	$93.33	$97.72
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 $64.57 / $70.79 / $74.13	Professional	TC	$64.57	$70.79	$74.13
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 $40.74 / $97.72 / $154.88	Professional		$40.74	$97.72	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $26.92 / $36.31	Professional	26	$13.80	$26.92	$36.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $72.44 / $120.23	Professional	TC	$30.20	$72.44	$120.23
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $85.11 / $331.13	Professional		$53.70	$85.11	$331.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $23.44 / $44.67	Professional	26	$15.14	$23.44	$44.67
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $54.95 / $295.12	Professional	TC	$38.90	$54.95	$295.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $112.20 / $177.83	Professional		$97.72	$112.20	$177.83
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $27.54 / $42.66	Professional	26	$23.99	$27.54	$42.66
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $81.28 / $134.90	Professional	TC	$74.13	$81.28	$134.90
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 $89.13 / $91.20 / $177.83	Professional		$89.13	$91.20	$177.83
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $28.84 / $42.66	Professional	26	$25.12	$28.84	$42.66
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $64.57 / $134.90	Professional	TC	$61.66	$64.57	$134.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $41.69 / $91.20	Professional		$13.49	$41.69	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $72.44 / $112.20	Professional		$48.98	$72.44	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $20.42 / $33.11	Professional	26	$14.13	$20.42	$33.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $51.29 / $81.28	Professional	TC	$35.48	$51.29	$81.28