Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $50.65 / $136.68	Facility	26	$14.13	$50.65	$136.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.78 / $131.97 / $335.00	Professional		$57.78	$131.97	$335.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.06 / $34.90 / $83.99	Professional	26	$14.06	$34.90	$83.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.72 / $61.03 / $116.85	Professional	TC	$43.72	$61.03	$116.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.57 / $61.36 / $61.36	Professional		$46.57	$61.36	$61.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.38 / $26.25 / $32.79	Professional	26	$19.38	$26.25	$32.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $85.55 / $85.55 / $85.55	Professional	TC	$85.55	$85.55	$85.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.48 / $112.76 / $115.58	Professional		$105.48	$112.76	$115.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.35 / $27.10 / $29.10	Professional	26	$25.35	$27.10	$29.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.15 / $85.68 / $87.81	Professional	TC	$80.15	$85.68	$87.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.98 / $79.98 / $79.98	Facility	26	$79.98	$79.98	$79.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.39 / $130.94 / $179.38	Professional		$65.39	$130.94	$179.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.30 / $32.08 / $41.69	Professional	26	$17.30	$32.08	$41.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.56 / $99.64 / $137.69	Professional	TC	$45.56	$99.64	$137.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $126.00 / $126.00 / $126.00	Facility	26	$126.00	$126.00	$126.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.37 / $108.10 / $399.42	Professional		$66.37	$108.10	$399.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $29.24 / $151.90	Professional	26	$17.82	$29.24	$151.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $48.54 / $80.54 / $307.58	Professional	TC	$48.54	$80.54	$307.58
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $53.35 / $54.91 / $79.98	Facility	26	$53.35	$54.91	$79.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $108.09 / $129.11 / $164.85	Professional		$108.09	$129.11	$164.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.05 / $55.59 / $103.37	Professional		$15.05	$55.59	$103.37
United Facility/Professional Professional Modifier Low / Median / High Price $66.37 / $108.10 / $135.68	Professional		$66.37	$108.10	$135.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $28.98 / $37.15	Professional	26	$17.82	$28.98	$37.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.54 / $78.86 / $99.22	Professional	TC	$48.54	$78.86	$99.22