Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $338.84 / $1,000.00	Facility	26	$134.90	$338.84	$1,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $478.63 / $2,089.30	Professional		$316.23	$478.63	$2,089.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $208.93 / $363.08	Professional	26	$104.71	$208.93	$363.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $338.84 / $724.44	Professional	TC	$208.93	$338.84	$724.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $331.13 / $707.95	Professional		$263.03	$331.13	$707.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $120.23 / $229.09	Professional	26	$83.18	$120.23	$229.09
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $218.78 / $218.78	Professional	TC	$218.78	$218.78	$218.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $602.56 / $645.65	Professional		$575.44	$602.56	$645.65
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $204.17 / $213.80	Professional	26	$190.55	$204.17	$213.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $398.11 / $549.54	Professional	TC	$371.54	$398.11	$549.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $602.56 / $602.56 / $602.56	Facility	26	$602.56	$602.56	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $776.25 / $1,348.96	Professional		$316.23	$776.25	$1,348.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $229.09 / $316.23	Professional	26	$100.00	$229.09	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $512.86 / $1,023.29	Professional	TC	$213.80	$512.86	$1,023.29
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Facility	26	$1,023.29	$1,023.29	$1,023.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $831.76 / $6,165.95	Professional		$416.87	$831.76	$6,165.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $208.93 / $933.25	Professional	26	$134.90	$208.93	$933.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $562.34 / $5,495.41	Professional	TC	$281.84	$562.34	$5,495.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $724.44 / $1,096.48	Professional		$616.60	$724.44	$1,096.48
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $239.88 / $371.54	Professional	26	$208.93	$239.88	$371.54
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $489.78 / $741.31	Professional	TC	$416.87	$489.78	$741.31
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $602.56 / $602.56 / $602.56	Facility	26	$602.56	$602.56	$602.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,096.48 / $1,905.46	Professional		$724.44	$1,096.48	$1,905.46
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $239.88 / $245.47 / $371.54	Professional	26	$239.88	$245.47	$371.54
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $741.31 / $1,659.59	Professional	TC	$478.63	$741.31	$1,659.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $234.42 / $537.03	Professional		$109.65	$234.42	$537.03
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $676.08 / $1,047.13	Professional		$380.19	$676.08	$1,047.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $208.93 / $281.84	Professional	26	$117.49	$208.93	$281.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $457.09 / $831.76	Professional	TC	$257.04	$457.09	$831.76