Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.06 / $177.23 / $492.80	Facility		$39.06	$177.23	$492.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.68 / $24.53 / $73.30	Facility	26	$7.68	$24.53	$73.30
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.84 / $94.00 / $352.32	Facility	TC	$26.84	$94.00	$352.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.55 / $30.05 / $123.00	Professional		$16.55	$30.05	$123.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.63 / $17.80 / $38.84	Professional	26	$7.63	$17.80	$38.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.35 / $36.11 / $53.02	Professional	TC	$21.35	$36.11	$53.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.23 / $69.47 / $69.47	Professional		$24.23	$69.47	$69.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.68 / $10.16 / $15.37	Professional	26	$5.68	$10.16	$15.37
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $42.90 / $42.90 / $42.90	Professional	TC	$42.90	$42.90	$42.90
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 $54.89 / $58.68 / $60.14	Professional		$54.89	$58.68	$60.14
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $14.52 / $15.90	Professional	26	$13.58	$14.52	$15.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.31 / $44.15 / $45.25	Professional	TC	$41.31	$44.15	$45.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.16 / $173.16 / $326.00	Facility		$173.16	$173.16	$326.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.84 / $42.84 / $42.84	Facility	26	$42.84	$42.84	$42.84
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 $31.66 / $67.41 / $93.08	Professional		$31.66	$67.41	$93.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.16 / $16.93 / $21.33	Professional	26	$9.16	$16.93	$21.33
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 $30.58 / $59.29 / $348.68	Facility		$30.58	$59.29	$348.68
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $21.14 / $100.00 / $100.00	Facility	26	$21.14	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $110.49 / $110.49 / $474.24	Facility	TC	$110.49	$110.49	$474.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.72 / $56.43 / $204.50	Professional		$34.72	$56.43	$204.50
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.81 / $15.93 / $74.30	Professional	26	$9.81	$15.93	$74.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.92 / $40.50 / $176.00	Professional	TC	$24.92	$40.50	$176.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $67.41 / $108.68	Facility		$56.00	$67.41	$108.68
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $26.72 / $27.50 / $42.84	Facility	26	$26.72	$27.50	$42.84
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $42.90 / $69.48 / $130.32	Facility	TC	$42.90	$69.48	$130.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $51.27 / $64.28 / $83.66	Professional		$51.27	$64.28	$83.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.17 / $25.75 / $53.85	Professional		$8.17	$25.75	$53.85
United Facility/Professional Professional Modifier Low / Median / High Price $31.76 / $55.76 / $70.98	Professional		$31.76	$55.76	$70.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.81 / $15.74 / $20.04	Professional	26	$9.81	$15.74	$20.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.92 / $40.50 / $50.95	Professional	TC	$24.92	$40.50	$50.95