Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.50 / $298.12 / $502.50	Facility	26	$55.50	$298.12	$502.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $219.97 / $285.95 / $1,361.63	Professional		$219.97	$285.95	$1,361.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.50 / $129.62 / $142.96	Professional	26	$55.50	$129.62	$142.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $164.47 / $345.83 / $438.26	Professional	TC	$164.47	$345.83	$438.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $106.02 / $106.02 / $106.02	Professional	26	$106.02	$106.02	$106.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $325.48 / $325.48 / $325.48	Professional	TC	$325.48	$325.48	$325.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $405.92 / $433.88 / $455.33	Professional		$405.92	$433.88	$455.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $101.12 / $108.08 / $114.88	Professional	26	$101.12	$108.08	$114.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $304.80 / $325.80 / $340.44	Professional	TC	$304.80	$325.80	$340.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $318.95 / $318.95 / $318.95	Facility	26	$318.95	$318.95	$318.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.75 / $536.50 / $749.52	Professional		$296.75	$536.50	$749.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.12 / $126.93 / $163.87	Professional	26	$73.12	$126.93	$163.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $225.64 / $406.85 / $586.00	Professional	TC	$225.64	$406.85	$586.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $537.20 / $537.20 / $537.20	Facility	26	$537.20	$537.20	$537.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $329.51 / $524.05 / $2,195.67	Professional		$329.51	$524.05	$2,195.67
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $70.08 / $117.66 / $439.20	Professional	26	$70.08	$117.66	$439.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $252.30 / $406.40 / $1,890.23	Professional	TC	$252.30	$406.40	$1,890.23
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $186.81 / $192.25 / $318.95	Facility	26	$186.81	$192.25	$318.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $439.60 / $546.29 / $733.00	Professional		$439.60	$546.29	$733.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.36 / $200.14 / $413.17	Professional		$57.36	$200.14	$413.17
United Facility/Professional Professional Modifier Low / Median / High Price $329.51 / $494.27 / $633.67	Professional		$329.51	$494.27	$633.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.08 / $114.44 / $144.38	Professional	26	$70.08	$114.44	$144.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $252.30 / $395.07 / $471.81	Professional	TC	$252.30	$395.07	$471.81