Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $30.90 / $95.50	Facility	26	$21.88	$30.90	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $36.31 / $173.78	Professional		$23.99	$36.31	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.96 / $48.98	Professional	26	$7.94	$10.96	$48.98
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $54.95 / $54.95 / $54.95	Professional	52	$54.95	$54.95	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $25.12 / $123.03	Professional	TC	$15.85	$25.12	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $63.10	Professional		$19.95	$19.95	$63.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $13.18 / $17.38	Professional	26	$13.18	$13.18	$17.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $52.48 / $54.95	Professional		$50.12	$52.48	$54.95
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 $33.88 / $35.48 / $37.15	Professional	TC	$33.88	$35.48	$37.15
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 Professional Modifier Low / Median / High Price $25.70 / $61.66 / $85.11	Professional		$25.70	$61.66	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $19.05 / $25.70	Professional	26	$9.12	$19.05	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $42.66 / $58.88	Professional	TC	$21.38	$42.66	$58.88
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 Professional Modifier Low / Median / High Price $34.67 / $53.70 / $213.80	Professional		$34.67	$53.70	$213.80
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.60 / $79.43	Professional	26	$10.96	$16.60	$79.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $36.31 / $204.17	Professional	TC	$23.99	$36.31	$204.17
Midlands Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $61.66 / $97.72	Professional		$54.95	$61.66	$97.72
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 $37.15 / $42.66 / $67.61	Professional	TC	$37.15	$42.66	$67.61
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 Professional Modifier Low / Median / High Price $60.26 / $64.57 / $97.72	Professional		$60.26	$64.57	$97.72
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $19.95 / $30.90	Professional	26	$16.98	$19.95	$30.90
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $44.67 / $67.61	Professional	TC	$40.74	$44.67	$67.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $21.88 / $51.29	Professional		$9.77	$21.88	$51.29
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $47.86 / $74.13	Professional		$31.62	$47.86	$74.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $14.79 / $22.91	Professional	26	$10.23	$14.79	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.11 / $51.29	Professional	TC	$21.88	$33.11	$51.29