Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.39 / $146.65 / $412.34	Facility	26	$45.39	$146.65	$412.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.23 / $256.77 / $986.17	Professional		$126.23	$256.77	$986.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.13 / $95.41 / $219.30	Professional	26	$43.13	$95.41	$219.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $80.84 / $83.05 / $303.82	Professional	TC	$80.84	$83.05	$303.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.89 / $65.13 / $105.80	Professional	26	$34.89	$65.13	$105.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $150.88 / $150.88 / $150.88	Professional	TC	$150.88	$150.88	$150.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $230.75 / $246.66 / $261.30	Professional		$230.75	$246.66	$261.30
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.23 / $88.95 / $93.56	Professional	26	$83.23	$88.95	$93.56
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.53 / $157.69 / $167.34	Professional	TC	$147.53	$157.69	$167.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $262.50 / $262.50 / $262.50	Facility	26	$262.50	$262.50	$262.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.40 / $294.80 / $447.20	Professional		$202.40	$294.80	$447.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.42 / $104.44 / $133.81	Professional	26	$60.42	$104.44	$133.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.97 / $188.60 / $288.68	Professional	TC	$141.97	$188.60	$288.68
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $442.24 / $442.24 / $442.24	Facility	26	$442.24	$442.24	$442.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $189.28 / $316.14 / $1,609.32	Professional		$189.28	$316.14	$1,609.32
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $62.61 / $95.32 / $379.76	Professional	26	$62.61	$95.32	$379.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $125.93 / $221.34 / $1,318.35	Professional	TC	$125.93	$221.34	$1,318.35
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $153.78 / $158.26 / $262.50	Facility	26	$153.78	$158.26	$262.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $249.92 / $341.90 / $492.00	Professional		$249.92	$341.90	$492.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.52 / $116.86 / $216.59	Professional		$47.52	$116.86	$216.59
United Facility/Professional Professional Modifier Low / Median / High Price $189.28 / $289.89 / $364.00	Professional		$189.28	$289.89	$364.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.48 / $95.32 / $121.83	Professional	26	$58.48	$95.32	$121.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.93 / $188.90 / $242.17	Professional	TC	$125.93	$188.90	$242.17