Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $186.21 / $263.03 / $812.83	Facility	26	$186.21	$263.03	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $478.63 / $1,778.28	Professional		$263.03	$478.63	$1,778.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $141.25 / $457.09	Professional	26	$81.28	$141.25	$457.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $302.00 / $489.78	Professional	TC	$181.97	$302.00	$489.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $63.10 / $190.55	Professional	26	$63.10	$63.10	$190.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $134.90 / $134.90	Professional	TC	$134.90	$134.90	$134.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $512.86 / $549.54	Professional		$478.63	$512.86	$549.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $158.49 / $169.82	Professional	26	$147.91	$158.49	$169.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $354.81 / $478.63	Professional	TC	$323.59	$354.81	$478.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $467.74 / $467.74 / $467.74	Facility	26	$467.74	$467.74	$467.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $645.65 / $933.25	Professional		$263.03	$645.65	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $169.82 / $245.47	Professional	26	$77.62	$169.82	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $446.68 / $776.25	Professional	TC	$186.21	$446.68	$776.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $794.33 / $794.33 / $794.33	Facility	26	$794.33	$794.33	$794.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $660.69 / $3,467.37	Professional		$346.74	$660.69	$3,467.37
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $165.96 / $660.69	Professional	26	$102.33	$165.96	$660.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $489.78 / $3,019.95	Professional	TC	$245.47	$489.78	$3,019.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $616.60 / $933.25	Professional		$524.81	$616.60	$933.25
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $186.21 / $288.40	Professional	26	$162.18	$186.21	$288.40
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $426.58 / $645.65	Professional	TC	$363.08	$426.58	$645.65
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $467.74 / $467.74 / $467.74	Facility	26	$467.74	$467.74	$467.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $933.25 / $1,071.52	Professional		$616.60	$933.25	$1,071.52
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $173.78 / $288.40	Professional	26	$169.82	$173.78	$288.40
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $645.65 / $912.01	Professional	TC	$416.87	$645.65	$912.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $194.98 / $457.09	Professional		$85.11	$194.98	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $575.44 / $891.25	Professional		$316.23	$575.44	$891.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $154.88 / $218.78	Professional	26	$91.20	$154.88	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $398.11 / $575.44	Professional	TC	$223.87	$398.11	$575.44