Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.38 / $219.52 / $446.03	Facility		$53.38	$219.52	$446.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.68 / $24.53 / $70.25	Facility	26	$7.68	$24.53	$70.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.69 / $141.43 / $424.32	Facility	TC	$28.69	$141.43	$424.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.16 / $37.96 / $143.00	Professional		$14.16	$37.96	$143.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $18.72 / $38.64	Professional	26	$7.66	$18.72	$38.64
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $214.00 / $214.00 / $214.00	Professional	50	$214.00	$214.00	$214.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.80 / $15.89 / $94.43	Professional	52	$15.80	$15.89	$94.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.22 / $42.08 / $114.00	Professional	TC	$22.22	$42.08	$114.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $11.03 / $17.91	Professional	26	$8.23	$11.03	$17.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $45.28 / $45.28 / $45.28	Professional	TC	$45.28	$45.28	$45.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.78 / $203.94 / $373.43	Facility		$146.78	$203.94	$373.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.32 / $62.34 / $63.89	Professional		$58.32	$62.34	$63.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.15 / $15.11 / $15.90	Professional	26	$14.15	$15.11	$15.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.06 / $47.21 / $48.39	Professional	TC	$43.06	$47.21	$48.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $183.96 / $183.96 / $326.00	Facility		$183.96	$183.96	$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 $139.32 / $139.32 / $139.32	Facility	TC	$139.32	$139.32	$139.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.84 / $71.65 / $97.93	Professional		$35.84	$71.65	$97.93
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 $25.74 / $54.01 / $75.63	Professional	TC	$25.74	$54.01	$75.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.59 / $61.03 / $319.89	Facility		$31.59	$61.03	$319.89
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 $116.58 / $116.58 / $259.20	Facility	TC	$116.58	$116.58	$259.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $58.99 / $217.55	Professional		$36.29	$58.99	$217.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $15.93 / $59.45	Professional	26	$9.80	$15.93	$59.45
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.50 / $43.06 / $166.53	Professional	TC	$26.50	$43.06	$166.53
Midlands Facility/Professional Facility Modifier Low / Median / High Price $54.31 / $71.65 / $106.07	Facility		$54.31	$71.65	$106.07
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $30.37 / $31.26 / $44.64	Facility	26	$30.37	$31.26	$44.64
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $45.28 / $74.81 / $139.32	Facility	TC	$45.28	$74.81	$139.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $65.98 / $85.27	Professional		$46.00	$65.98	$85.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.31 / $27.92 / $57.67	Professional		$8.31	$27.92	$57.67
United Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $58.29 / $74.20	Professional		$36.29	$58.29	$74.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $15.32 / $20.04	Professional	26	$9.80	$15.32	$20.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.50 / $43.06 / $54.16	Professional	TC	$26.50	$43.06	$54.16