Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.43 / $259.20 / $441.05	Facility		$35.43	$259.20	$441.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.71 / $23.47 / $67.20	Facility	26	$7.71	$23.47	$67.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.49 / $144.90 / $372.53	Facility	TC	$23.49	$144.90	$372.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.21 / $39.10 / $119.78	Professional		$15.21	$39.10	$119.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.30 / $17.09 / $42.40	Professional	26	$7.30	$17.09	$42.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $202.00 / $202.00 / $202.00	Professional	50	$202.00	$202.00	$202.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $27.31 / $80.58	Professional	TC	$18.82	$27.31	$80.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $14.33 / $17.91	Professional	26	$8.23	$14.33	$17.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.54 / $19.54 / $38.90	Professional	TC	$19.54	$19.54	$38.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.78 / $215.27 / $373.43	Facility		$146.78	$215.27	$373.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.32 / $53.79 / $55.14	Professional		$50.32	$53.79	$55.14
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.15 / $15.11 / $15.50	Professional	26	$14.15	$15.11	$15.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.15 / $38.65 / $39.63	Professional	TC	$36.15	$38.65	$39.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $158.76 / $158.76 / $326.00	Facility		$158.76	$158.76	$326.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.64 / $44.64 / $44.64	Facility	26	$44.64	$44.64	$44.64
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $114.12 / $114.12 / $114.12	Facility	TC	$114.12	$114.12	$114.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.85 / $61.73 / $85.33	Professional		$28.85	$61.73	$85.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $17.63 / $22.30	Professional	26	$9.41	$17.63	$22.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.68 / $44.10 / $63.03	Professional	TC	$20.68	$44.10	$63.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.26 / $57.24 / $342.77	Facility		$27.26	$57.24	$342.77
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $53.20 / $100.00 / $100.00	Facility	26	$53.20	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $100.00 / $162.18 / $270.75	Facility	TC	$100.00	$162.18	$270.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $51.30 / $187.12	Professional		$31.57	$51.30	$187.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $15.52 / $67.70	Professional	26	$9.80	$15.52	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.77 / $35.36 / $160.00	Professional	TC	$21.77	$35.36	$160.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $51.91 / $61.73 / $96.22	Facility		$51.91	$61.73	$96.22
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $24.94 / $25.66 / $44.64	Facility	26	$24.94	$25.66	$44.64
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $37.58 / $69.59 / $114.12	Facility	TC	$37.58	$69.59	$114.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $58.30 / $73.73	Professional		$46.00	$58.30	$73.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.18 / $22.87 / $49.50	Professional		$8.18	$22.87	$49.50
United Facility/Professional Facility Modifier Low / Median / High Price $81.70 / $163.63 / $206.53	Facility		$81.70	$163.63	$206.53
United Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $50.70 / $64.54	Professional		$31.57	$50.70	$64.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $15.74 / $20.04	Professional	26	$9.80	$15.74	$20.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.77 / $35.36 / $44.50	Professional	TC	$21.77	$35.36	$44.50