Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.59 / $217.34 / $613.16	Facility	26	$67.59	$217.34	$613.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.58 / $471.70 / $1,256.96	Professional		$186.58	$471.70	$1,256.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.59 / $146.50 / $271.00	Professional	26	$67.59	$146.50	$271.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $93.29 / $93.29 / $1,224.19	Professional	52	$93.29	$93.29	$1,224.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $118.99 / $315.47 / $485.75	Professional	TC	$118.99	$315.47	$485.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.86 / $146.66 / $425.97	Professional		$139.86	$146.66	$425.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $72.33 / $125.93 / $157.36	Professional	26	$72.33	$125.93	$157.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $88.19 / $88.19 / $220.48	Professional	TC	$88.19	$88.19	$220.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $340.80 / $364.27 / $386.22	Professional		$340.80	$364.27	$386.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.95 / $132.50 / $139.91	Professional	26	$123.95	$132.50	$139.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $216.84 / $231.78 / $246.31	Professional	TC	$216.84	$231.78	$246.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $391.02 / $391.02 / $391.02	Facility	26	$391.02	$391.02	$391.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $249.43 / $433.58 / $669.16	Professional		$249.43	$433.58	$669.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.57 / $155.19 / $198.77	Professional	26	$89.57	$155.19	$198.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $159.87 / $275.60 / $559.34	Professional	TC	$159.87	$275.60	$559.34
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $659.84 / $659.84 / $659.84	Facility	26	$659.84	$659.84	$659.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $305.37 / $494.90 / $3,145.84	Professional		$305.37	$494.90	$3,145.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $86.72 / $140.91 / $222.60	Professional	26	$86.72	$140.91	$222.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $196.98 / $328.30 / $2,772.01	Professional	TC	$196.98	$328.30	$2,772.01
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $227.86 / $234.49 / $391.02	Facility	26	$227.86	$234.49	$391.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $369.09 / $485.32 / $886.14	Professional		$369.09	$485.32	$886.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.65 / $179.27 / $320.00	Professional		$70.65	$179.27	$320.00
United Facility/Professional Professional Modifier Low / Median / High Price $305.37 / $441.74 / $576.91	Professional		$305.37	$441.74	$576.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.89 / $140.91 / $180.65	Professional	26	$84.89	$140.91	$180.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $157.58 / $288.89 / $462.43	Professional	TC	$157.58	$288.89	$462.43