Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $309.03 / $524.81	Facility		$57.54	$309.03	$524.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $16.98 / $66.07	Facility	26	$10.47	$16.98	$66.07
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $38.90 / $104.71 / $575.44	Facility	TC	$38.90	$104.71	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $34.67 / $93.33	Professional		$9.77	$34.67	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $14.13 / $37.15	Professional	26	$7.76	$14.13	$37.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $20.42 / $158.49 / $186.21	Professional	50	$20.42	$158.49	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $37.15 / $87.10	Professional	TC	$21.88	$37.15	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $31.62 / $61.66	Professional		$20.42	$31.62	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.55 / $16.60	Professional	26	$6.46	$9.55	$16.60
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $30.20 / $36.31 / $57.54	Professional	50	$30.20	$36.31	$57.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $28.84 / $44.67	Professional	TC	$15.14	$28.84	$44.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $181.97 / $380.19	Facility		$147.91	$181.97	$380.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $58.88 / $61.66	Professional		$56.23	$58.88	$61.66
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $15.49 / $16.60	Professional	26	$14.79	$15.49	$16.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $43.65 / $45.71	Professional	TC	$40.74	$43.65	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $323.59	Facility		$177.83	$177.83	$323.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $46.77 / $46.77	Facility	26	$46.77	$46.77	$46.77
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $131.83 / $131.83 / $131.83	Facility	TC	$131.83	$131.83	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $61.66 / $97.72	Professional		$25.12	$61.66	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $16.98 / $23.99	Professional	26	$7.59	$16.98	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $45.71 / $74.13	Professional	TC	$19.05	$45.71	$74.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $165.96 / $416.87	Facility		$38.90	$165.96	$416.87
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 Facility Modifier TC Low / Median / High Price $109.65 / $109.65 / $331.13	Facility	TC	$109.65	$109.65	$331.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $53.70 / $208.93	Professional		$34.67	$53.70	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.49 / $24.55	Professional	26	$8.91	$15.49	$24.55
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $33.88 / $177.83	Professional	TC	$23.99	$33.88	$177.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $69.18 / $112.20	Professional		$61.66	$69.18	$112.20
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $18.62 / $28.18	Professional	26	$16.22	$18.62	$28.18
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $50.12 / $83.18	Professional	TC	$45.71	$50.12	$83.18
Midlands Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $46.77 / $46.77	Facility	26	$46.77	$46.77	$46.77
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $42.66 / $131.83 / $131.83	Facility	TC	$42.66	$131.83	$131.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $112.20	Professional		$54.95	$54.95	$112.20
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $16.98 / $28.18	Professional	26	$14.13	$16.98	$28.18
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $40.74 / $83.18	Professional	TC	$38.02	$40.74	$83.18
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $2,290.87	Facility		$1,949.84	$1,949.84	$2,290.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $25.70 / $56.23	Professional		$8.71	$25.70	$56.23
United Facility/Professional Facility Modifier Low / Median / High Price $9.33 / $81.28 / $204.17	Facility		$9.33	$81.28	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $45.71 / $70.79	Professional		$31.62	$45.71	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.49 / $21.38	Professional	26	$8.91	$13.49	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $32.36 / $51.29	Professional	TC	$22.39	$32.36	$51.29