Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $309.03 / $588.84	Facility		$53.70	$309.03	$588.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $19.50 / $257.04	Facility	26	$11.22	$19.50	$257.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $41.69 / $281.84 / $645.65	Facility	TC	$41.69	$281.84	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $38.02 / $100.00	Professional		$9.12	$38.02	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.18 / $42.66	Professional	26	$8.13	$13.18	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.05 / $64.57 / $165.96	Professional	50	$19.05	$64.57	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $39.81 / $100.00	Professional	TC	$21.38	$39.81	$100.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $31.62 / $61.66	Professional		$21.38	$31.62	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.47 / $17.38	Professional	26	$6.92	$10.47	$17.38
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $31.62 / $35.48 / $95.50	Professional	50	$31.62	$35.48	$95.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $28.18 / $46.77	Professional	TC	$17.38	$28.18	$46.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $173.78 / $371.54	Facility		$141.25	$173.78	$371.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $63.10 / $66.07	Professional		$57.54	$63.10	$66.07
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $16.98 / $17.78	Professional	26	$15.85	$16.98	$17.78
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $45.71 / $47.86	Professional	TC	$40.74	$45.71	$47.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $323.59	Facility		$190.55	$190.55	$323.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $50.12 / $50.12	Facility	26	$50.12	$50.12	$50.12
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $138.04 / $138.04 / $138.04	Facility	TC	$138.04	$138.04	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $64.57 / $102.33	Professional		$26.30	$64.57	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $18.20 / $25.70	Professional	26	$8.13	$18.20	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $45.71 / $77.62	Professional	TC	$19.50	$45.71	$77.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $309.03 / $436.52	Facility		$53.70	$309.03	$436.52
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $100.00 / $100.00	Facility	26	$23.44	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $117.49 / $346.74 / $457.09	Facility	TC	$117.49	$346.74	$457.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $223.87	Professional		$32.36	$50.12	$223.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.98 / $22.39	Professional	26	$10.96	$16.98	$22.39
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $34.67 / $177.83	Professional	TC	$23.44	$34.67	$177.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $72.44 / $117.49	Professional		$66.07	$72.44	$117.49
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $19.95 / $30.90	Professional	26	$17.38	$19.95	$30.90
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $47.86 / $87.10	Professional	TC	$38.02	$47.86	$87.10
Midlands Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $50.12 / $50.12	Facility	26	$50.12	$50.12	$50.12
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $45.71 / $138.04 / $138.04	Facility	TC	$45.71	$138.04	$138.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $56.23 / $117.49	Professional		$52.48	$56.23	$117.49
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $18.20 / $30.90	Professional	26	$15.14	$18.20	$30.90
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $53.70 / $87.10	Professional	TC	$38.02	$53.70	$87.10
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $2,290.87	Facility		$1,949.84	$1,949.84	$2,290.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $27.54 / $60.26	Professional		$9.33	$27.54	$60.26
United Facility/Professional Facility Modifier Low / Median / High Price $9.77 / $81.28 / $204.17	Facility		$9.77	$81.28	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $45.71 / $75.86	Professional		$32.36	$45.71	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $14.45 / $22.91	Professional	26	$9.77	$14.45	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $32.36 / $53.70	Professional	TC	$22.39	$32.36	$53.70