Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.47 / $349.04 / $945.52	Facility	26	$104.47	$349.04	$945.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.95 / $475.00 / $2,074.27	Professional		$312.95	$475.00	$2,074.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.37 / $243.11 / $567.02	Professional	26	$104.37	$243.11	$567.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.58 / $335.00 / $1,481.37	Professional	TC	$208.58	$335.00	$1,481.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $233.50 / $248.10 / $355.60	Professional		$233.50	$248.10	$355.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.96 / $143.96 / $243.59	Professional	26	$82.96	$143.96	$243.59
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $191.91 / $214.94 / $214.94	Professional	TC	$191.91	$214.94	$214.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $569.82 / $609.08 / $647.83	Professional		$569.82	$609.08	$647.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $191.16 / $204.34 / $216.05	Professional	26	$191.16	$204.34	$216.05
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $378.68 / $404.75 / $431.75	Professional	TC	$378.68	$404.75	$431.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $603.00 / $603.00 / $603.00	Facility	26	$603.00	$603.00	$603.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $420.14 / $724.33 / $1,102.68	Professional		$420.14	$724.33	$1,102.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $137.34 / $238.76 / $308.33	Professional	26	$137.34	$238.76	$308.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $282.80 / $484.19 / $849.92	Professional	TC	$282.80	$484.19	$849.92
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,016.96 / $1,016.96 / $1,016.96	Facility	26	$1,016.96	$1,016.96	$1,016.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $516.14 / $860.23 / $6,199.75	Professional		$516.14	$860.23	$6,199.75
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $147.37 / $221.27 / $931.20	Professional	26	$147.37	$221.27	$931.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $348.69 / $581.15 / $5,551.18	Professional	TC	$348.69	$581.15	$5,551.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $395.58 / $407.10 / $603.00	Facility	26	$395.58	$407.10	$603.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $617.11 / $785.05 / $1,484.12	Professional		$617.11	$785.05	$1,484.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $110.14 / $299.77 / $535.11	Professional		$110.14	$299.77	$535.11
United Facility/Professional Professional Modifier Low / Median / High Price $412.91 / $747.06 / $1,055.25	Professional		$412.91	$747.06	$1,055.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $133.96 / $219.18 / $279.08	Professional	26	$133.96	$219.18	$279.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $278.95 / $536.87 / $734.78	Professional	TC	$278.95	$536.87	$734.78