Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.49 / $167.78 / $335.59	Facility		$39.49	$167.78	$335.59
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.03 / $25.61 / $72.20	Facility	26	$8.03	$25.61	$72.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.96 / $98.86 / $217.42	Facility	TC	$23.96	$98.86	$217.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.48 / $58.43 / $156.00	Professional		$29.48	$58.43	$156.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $17.97 / $38.84	Professional	26	$7.78	$17.97	$38.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.69 / $39.10 / $116.00	Professional	TC	$21.69	$39.10	$116.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.98 / $70.98 / $70.98	Professional		$70.98	$70.98	$70.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $14.73 / $18.69	Professional	26	$6.17	$14.73	$18.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.40 / $44.40 / $44.40	Professional	TC	$44.40	$44.40	$44.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.78 / $198.92 / $373.43	Facility		$146.78	$198.92	$373.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.09 / $59.96 / $61.46	Professional		$56.09	$59.96	$61.46
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.77 / $15.80 / $16.60	Professional	26	$14.77	$15.80	$16.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.03 / $44.15 / $45.25	Professional	TC	$40.03	$44.15	$45.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $176.94 / $176.94 / $326.00	Facility		$176.94	$176.94	$326.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.62 / $46.62 / $46.62	Facility	26	$46.62	$46.62	$46.62
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $130.32 / $130.32 / $130.32	Facility	TC	$130.32	$130.32	$130.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.71 / $68.89 / $95.02	Professional		$31.71	$68.89	$95.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $18.41 / $23.27	Professional	26	$9.77	$18.41	$23.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.79 / $50.48 / $71.75	Professional	TC	$23.79	$50.48	$71.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.38 / $57.90 / $277.20	Facility		$30.38	$57.90	$277.20
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $110.49 / $110.49 / $443.52	Facility	TC	$110.49	$110.49	$443.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.76 / $56.49 / $208.83	Professional		$34.76	$56.49	$208.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.24 / $16.63 / $82.56	Professional	26	$10.24	$16.63	$82.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.52 / $39.86 / $176.00	Professional	TC	$24.52	$39.86	$176.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $68.89 / $109.03	Facility		$56.00	$68.89	$109.03
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $26.79 / $27.57 / $46.62	Facility	26	$26.79	$27.57	$46.62
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $42.90 / $67.51 / $130.32	Facility	TC	$42.90	$67.51	$130.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $51.27 / $63.46 / $83.66	Professional		$51.27	$63.46	$83.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $25.40 / $53.91	Professional		$8.51	$25.40	$53.91
United Facility/Professional Professional Modifier Low / Median / High Price $34.76 / $55.83 / $71.06	Professional		$34.76	$55.83	$71.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.24 / $16.44 / $20.92	Professional	26	$10.24	$16.44	$20.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.52 / $35.76 / $50.14	Professional	TC	$24.52	$35.76	$50.14