Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $234.42 / $1,000.00	Facility	26	$134.90	$234.42	$1,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $501.19 / $1,659.59	Professional		$309.03	$501.19	$1,659.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $223.87 / $380.19	Professional	26	$102.33	$223.87	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $338.84 / $741.31	Professional	TC	$208.93	$338.84	$741.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $588.84 / $741.31	Professional		$323.59	$588.84	$741.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $144.54 / $218.78	Professional	26	$89.13	$144.54	$218.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $158.49 / $389.05	Professional	TC	$158.49	$158.49	$389.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $602.56 / $645.65	Professional		$562.34	$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 / $389.05 / $537.03	Professional	TC	$371.54	$389.05	$537.03
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 / $758.58 / $1,380.38	Professional		$316.23	$758.58	$1,380.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $218.78 / $316.23	Professional	26	$100.00	$218.78	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $512.86 / $1,122.02	Professional	TC	$213.80	$512.86	$1,122.02
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 / $912.01	Professional	26	$134.90	$208.93	$912.01
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $562.34 / $5,495.41	Professional	TC	$275.42	$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 / $478.63 / $724.44	Professional	TC	$416.87	$478.63	$724.44
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 $218.78 / $229.09 / $371.54	Professional	26	$218.78	$229.09	$371.54
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $724.44 / $1,659.59	Professional	TC	$478.63	$724.44	$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 / $199.53 / $281.84	Professional	26	$117.49	$199.53	$281.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $457.09 / $851.14	Professional	TC	$257.04	$457.09	$851.14