Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.72 / $301.16 / $544.79	Facility		$57.72	$301.16	$544.79
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.03 / $20.14 / $73.30	Facility	26	$8.03	$20.14	$73.30
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.84 / $147.59 / $575.29	Facility	TC	$26.84	$147.59	$575.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.21 / $35.00 / $130.19	Professional		$11.21	$35.00	$130.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $18.19 / $40.76	Professional	26	$7.90	$18.19	$40.76
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $20.50 / $39.06 / $228.00	Professional	50	$20.50	$39.06	$228.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.37 / $45.24 / $114.00	Professional	TC	$22.37	$45.24	$114.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.30 / $55.93 / $70.98	Professional		$23.30	$55.93	$70.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $11.51 / $18.69	Professional	26	$6.76	$11.51	$18.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.75 / $25.75 / $42.90	Professional	TC	$25.75	$25.75	$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 $56.65 / $60.56 / $62.07	Professional		$56.65	$60.56	$62.07
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.77 / $15.80 / $16.60	Professional	26	$14.77	$15.80	$16.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.88 / $44.74 / $45.88	Professional	TC	$41.88	$44.74	$45.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $178.74 / $178.74 / $326.00	Facility		$178.74	$178.74	$326.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.62 / $46.62 / $46.62	Facility	26	$46.62	$46.62	$46.62
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $132.12 / $132.12 / $132.12	Facility	TC	$132.12	$132.12	$132.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.54 / $68.89 / $95.02	Professional		$33.54	$68.89	$95.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $18.41 / $23.27	Professional	26	$9.77	$18.41	$23.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.01 / $50.48 / $71.75	Professional	TC	$23.01	$50.48	$71.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.10 / $71.78 / $367.68	Facility		$45.10	$71.78	$367.68
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 $110.49 / $110.49 / $332.94	Facility	TC	$110.49	$110.49	$332.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.36 / $56.64 / $208.83	Professional		$34.36	$56.64	$208.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.19 / $16.01 / $74.30	Professional	26	$10.19	$16.01	$74.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.13 / $41.31 / $176.00	Professional	TC	$24.13	$41.31	$176.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $68.89 / $110.95	Facility		$60.00	$68.89	$110.95
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $26.69 / $27.46 / $46.62	Facility	26	$26.69	$27.46	$46.62
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $42.90 / $83.81 / $132.12	Facility	TC	$42.90	$83.81	$132.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $51.27 / $65.94 / $82.28	Professional		$51.27	$65.94	$82.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $26.48 / $55.55	Professional		$8.51	$26.48	$55.55
United Facility/Professional Professional Modifier Low / Median / High Price $34.36 / $56.64 / $70.25	Professional		$34.36	$56.64	$70.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.24 / $16.44 / $20.92	Professional	26	$10.24	$16.44	$20.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.13 / $40.98 / $50.27	Professional	TC	$24.13	$40.98	$50.27