Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $177.83 / $549.54	Facility	26	$128.82	$177.83	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $257.04 / $1,096.48	Professional		$162.18	$257.04	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $107.15 / $223.87	Professional	26	$52.48	$107.15	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $173.78 / $371.54	Professional	TC	$107.15	$173.78	$371.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $43.65 / $46.77	Professional	26	$43.65	$43.65	$46.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $316.23 / $338.84	Professional		$302.00	$316.23	$338.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $107.15 / $114.82	Professional	26	$102.33	$107.15	$114.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $213.80 / $346.74	Professional	TC	$194.98	$213.80	$346.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $323.59 / $323.59 / $323.59	Facility	26	$323.59	$323.59	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $407.38 / $575.44	Professional		$190.55	$407.38	$575.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $112.20 / $165.96	Professional	26	$52.48	$112.20	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $269.15 / $407.38	Professional	TC	$131.83	$269.15	$407.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $537.03 / $537.03 / $537.03	Facility	26	$537.03	$537.03	$537.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $363.08 / $1,862.09	Professional		$218.78	$363.08	$1,862.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $112.20 / $436.52	Professional	26	$70.79	$112.20	$436.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $269.15 / $1,584.89	Professional	TC	$147.91	$269.15	$1,584.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $380.19 / $575.44	Professional		$331.13	$380.19	$575.44
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $125.89 / $194.98	Professional	26	$112.20	$125.89	$194.98
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $251.19 / $389.05	Professional	TC	$218.78	$251.19	$389.05
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $323.59 / $323.59 / $323.59	Facility	26	$323.59	$323.59	$323.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $575.44 / $588.84	Professional		$380.19	$575.44	$588.84
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $120.23 / $194.98	Professional	26	$107.15	$120.23	$194.98
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $389.05 / $478.63	Professional	TC	$251.19	$389.05	$478.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $125.89 / $288.40	Professional		$58.88	$125.89	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $346.74 / $501.19	Professional		$199.53	$346.74	$501.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $107.15 / $147.91	Professional	26	$63.10	$107.15	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $234.42 / $323.59	Professional	TC	$138.04	$234.42	$323.59