Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.43 / $441.75 / $744.60	Facility	26	$81.43	$441.75	$744.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.37 / $252.89 / $1,559.29	Professional		$245.37	$252.89	$1,559.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.34 / $81.43 / $506.18	Professional	26	$78.34	$81.43	$506.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.94 / $163.94 / $1,053.10	Professional	TC	$163.94	$163.94	$1,053.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $189.86 / $189.86 / $189.86	Professional	26	$189.86	$189.86	$189.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $453.12 / $484.33 / $507.92	Professional		$453.12	$484.33	$507.92
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $148.91 / $159.16 / $168.56	Professional	26	$148.91	$159.16	$168.56
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $304.23 / $325.18 / $339.36	Professional	TC	$304.23	$325.18	$339.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $469.68 / $469.68 / $469.68	Facility	26	$469.68	$469.68	$469.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $352.96 / $597.42 / $909.10	Professional		$352.96	$597.42	$909.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.90 / $186.78 / $240.47	Professional	26	$98.90	$186.78	$240.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $244.70 / $406.85 / $667.10	Professional	TC	$244.70	$406.85	$667.10
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $792.40 / $792.40 / $792.40	Facility	26	$792.40	$792.40	$792.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $391.70 / $628.60 / $3,081.89	Professional		$391.70	$628.60	$3,081.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $104.50 / $172.63 / $554.78	Professional	26	$104.50	$172.63	$554.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $278.31 / $462.56 / $2,625.91	Professional	TC	$278.31	$462.56	$2,625.91
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $280.10 / $288.26 / $469.68	Facility	26	$280.10	$288.26	$469.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $490.73 / $625.00 / $909.10	Professional		$490.73	$625.00	$909.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.01 / $223.85 / $506.42	Professional		$85.01	$223.85	$506.42
United Facility/Professional Professional Modifier Low / Median / High Price $391.70 / $628.60 / $753.28	Professional		$391.70	$628.60	$753.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.50 / $170.08 / $212.03	Professional	26	$104.50	$170.08	$212.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $274.02 / $455.97 / $535.23	Professional	TC	$274.02	$455.97	$535.23