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 $125.61 / $321.81 / $896.36	Professional		$125.61	$321.81	$896.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.75 / $66.12 / $184.50	Professional	26	$43.75	$66.12	$184.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.97 / $128.13 / $276.17	Professional	TC	$76.97	$128.13	$276.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.89 / $80.33 / $105.80	Professional	26	$34.89	$80.33	$105.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $75.14 / $75.14 / $75.14	Professional	TC	$75.14	$75.14	$75.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.62 / $245.44 / $260.00	Professional		$229.62	$245.44	$260.00
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 $146.38 / $156.47 / $166.06	Professional	TC	$146.38	$156.47	$166.06
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 $201.62 / $294.05 / $446.08	Professional		$201.62	$294.05	$446.08
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 $141.21 / $187.85 / $287.56	Professional	TC	$141.21	$187.85	$287.56
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 $188.44 / $314.70 / $1,609.32	Professional		$188.44	$314.70	$1,609.32
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.35 / $95.32 / $379.76	Professional	26	$63.35	$95.32	$379.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $125.09 / $221.34 / $1,345.00	Professional	TC	$125.09	$221.34	$1,345.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $152.49 / $156.93 / $262.50	Facility	26	$152.49	$156.93	$262.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $248.68 / $350.04 / $492.00	Professional		$248.68	$350.04	$492.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.52 / $113.79 / $216.07	Professional		$47.52	$113.79	$216.07
United Facility/Professional Professional Modifier Low / Median / High Price $188.44 / $296.89 / $362.38	Professional		$188.44	$296.89	$362.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.48 / $95.02 / $121.83	Professional	26	$58.48	$95.02	$121.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $115.46 / $211.68 / $243.49	Professional	TC	$115.46	$211.68	$243.49