Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.73 / $83.90 / $226.93	Facility	26	$25.73	$83.90	$226.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.57 / $123.02 / $699.66	Professional		$97.57	$123.02	$699.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.88 / $25.53 / $64.04	Professional	26	$23.88	$25.53	$64.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.15 / $97.55 / $544.29	Professional	TC	$88.15	$97.55	$544.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.40 / $45.47 / $59.89	Professional	26	$35.40	$45.47	$59.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.69 / $242.50 / $248.56	Professional		$217.69	$242.50	$248.56
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.75 / $49.97 / $52.39	Professional	26	$46.75	$49.97	$52.39
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $172.81 / $192.50 / $197.31	Professional	TC	$172.81	$192.50	$197.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.54 / $147.54 / $147.54	Facility	26	$147.54	$147.54	$147.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.65 / $276.10 / $381.06	Professional		$121.65	$276.10	$381.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.23 / $58.46 / $76.59	Professional	26	$31.23	$58.46	$76.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.79 / $217.72 / $304.45	Professional	TC	$91.79	$217.72	$304.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $121.12 / $121.12 / $121.12	Facility	26	$121.12	$121.12	$121.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $134.47 / $218.54 / $859.12	Professional		$134.47	$218.54	$859.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.02 / $52.03 / $211.35	Professional	26	$32.02	$52.03	$211.35
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $98.50 / $166.51 / $689.44	Professional	TC	$98.50	$166.51	$689.44
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $85.40 / $87.88 / $147.54	Facility	26	$85.40	$87.88	$147.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $185.00 / $245.95 / $335.08	Professional		$185.00	$245.95	$335.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.16 / $116.30 / $223.66	Professional		$27.16	$116.30	$223.66
United Facility/Professional Professional Modifier Low / Median / High Price $134.47 / $218.54 / $280.18	Professional		$134.47	$218.54	$280.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.02 / $51.41 / $65.45	Professional	26	$32.02	$51.41	$65.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.46 / $164.55 / $209.46	Professional	TC	$102.46	$164.55	$209.46