Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $186.21 / $263.03 / $812.83	Facility	26	$186.21	$263.03	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $478.63 / $2,238.72	Professional		$331.13	$478.63	$2,238.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $141.25 / $245.47	Professional	26	$81.28	$141.25	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $338.84 / $660.69	Professional	TC	$245.47	$338.84	$660.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $630.96 / $676.08	Professional		$602.56	$630.96	$676.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $158.49 / $169.82	Professional	26	$147.91	$158.49	$169.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $478.63 / $512.86	Professional	TC	$446.68	$478.63	$512.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $467.74 / $467.74 / $467.74	Facility	26	$467.74	$467.74	$467.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $794.33 / $1,023.29	Professional		$331.13	$794.33	$1,023.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $173.78 / $245.47	Professional	26	$77.62	$173.78	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $602.56 / $794.33	Professional	TC	$251.19	$602.56	$794.33
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $794.33 / $794.33 / $794.33	Facility	26	$794.33	$794.33	$794.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $707.95 / $3,019.95	Professional		$426.58	$707.95	$3,019.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $165.96 / $602.56	Professional	26	$104.71	$165.96	$602.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $537.03 / $2,570.40	Professional	TC	$331.13	$537.03	$2,570.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $758.58 / $1,174.90	Professional		$660.69	$758.58	$1,174.90
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $186.21 / $288.40	Professional	26	$162.18	$186.21	$288.40
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $575.44 / $870.96	Professional	TC	$489.78	$575.44	$870.96
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $467.74 / $467.74 / $467.74	Facility	26	$467.74	$467.74	$467.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $933.25 / $1,174.90	Professional		$758.58	$933.25	$1,174.90
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $177.83 / $288.40	Professional	26	$144.54	$177.83	$288.40
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $575.44 / $758.58 / $870.96	Professional	TC	$575.44	$758.58	$870.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $263.03 / $562.34	Professional		$85.11	$263.03	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $660.69 / $933.25	Professional		$398.11	$660.69	$933.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $154.88 / $218.78	Professional	26	$91.20	$154.88	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $524.81 / $707.95	Professional	TC	$302.00	$524.81	$707.95