Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.31 / $331.29 / $698.66	Facility		$52.31	$331.29	$698.66
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.40 / $27.70 / $257.48	Facility	26	$10.40	$27.70	$257.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $37.36 / $288.00 / $669.76	Facility	TC	$37.36	$288.00	$669.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.90 / $38.56 / $116.06	Professional		$8.90	$38.56	$116.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $19.52 / $44.02	Professional	26	$8.52	$19.52	$44.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.05 / $77.00 / $248.00	Professional	50	$17.05	$77.00	$248.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.25 / $39.97 / $104.00	Professional	TC	$21.25	$39.97	$104.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.96 / $75.36 / $75.36	Professional		$25.96	$75.36	$75.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.69 / $12.44 / $20.20	Professional	26	$6.69	$12.44	$20.20
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $83.00 / $83.00 / $83.00	Professional	50	$83.00	$83.00	$83.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.11 / $45.28 / $46.86	Professional	TC	$18.11	$45.28	$46.86
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 $60.13 / $64.28 / $65.89	Professional		$60.13	$64.28	$65.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.96 / $17.05 / $17.94	Professional	26	$15.96	$17.05	$17.94
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.39 / $47.20 / $48.39	Professional	TC	$42.39	$47.20	$48.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $189.72 / $189.72 / $326.00	Facility		$189.72	$189.72	$326.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.40 / $50.40 / $50.40	Facility	26	$50.40	$50.40	$50.40
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $139.32 / $139.32 / $139.32	Facility	TC	$139.32	$139.32	$139.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.51 / $73.19 / $100.84	Professional		$33.51	$73.19	$100.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.54 / $19.88 / $25.21	Professional	26	$10.54	$19.88	$25.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.21 / $53.32 / $75.63	Professional	TC	$23.21	$53.32	$75.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.41 / $250.09 / $407.53	Facility		$48.41	$250.09	$407.53
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $23.50 / $100.00 / $100.00	Facility	26	$23.50	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $116.58 / $332.50 / $461.76	Facility	TC	$116.58	$332.50	$461.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.77 / $59.75 / $221.82	Professional		$36.77	$59.75	$221.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $17.61 / $27.19	Professional	26	$11.07	$17.61	$27.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $41.77 / $177.00	Professional	TC	$25.70	$41.77	$177.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $58.00 / $73.19 / $110.32	Facility		$58.00	$73.19	$110.32
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $32.07 / $33.01 / $50.40	Facility	26	$32.07	$33.01	$50.40
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $45.28 / $69.61 / $139.32	Facility	TC	$45.28	$69.61	$139.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $52.38 / $66.78 / $88.84	Professional		$52.38	$66.78	$88.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.16 / $30.93 / $59.96	Professional		$9.16	$30.93	$59.96
United Facility/Professional Professional Modifier Low / Median / High Price $36.77 / $59.05 / $75.16	Professional		$36.77	$59.05	$75.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.04 / $17.21 / $22.62	Professional	26	$11.04	$17.21	$22.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $41.77 / $52.54	Professional	TC	$25.70	$41.77	$52.54