Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.59 / $225.75 / $478.72	Facility		$68.59	$225.75	$478.72
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $25.61 / $114.92	Facility	26	$9.61	$25.61	$114.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.61 / $255.36 / $469.44	Facility	TC	$39.61	$255.36	$469.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.92 / $38.11 / $152.58	Professional		$8.92	$38.11	$152.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $19.46 / $41.36	Professional	26	$7.90	$19.46	$41.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.85 / $39.06 / $141.91	Professional	50	$17.85	$39.06	$141.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.75 / $52.85 / $145.00	Professional	TC	$28.75	$52.85	$145.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.73 / $89.76 / $93.59	Professional		$70.73	$89.76	$93.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.37 / $11.82 / $18.69	Professional	26	$6.37	$11.82	$18.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.00 / $58.34 / $60.38	Professional	TC	$35.00	$58.34	$60.38
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 $70.93 / $75.81 / $77.70	Professional		$70.93	$75.81	$77.70
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 $55.03 / $60.03 / $61.53	Professional	TC	$55.03	$60.03	$61.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $223.74 / $223.74 / $326.00	Facility		$223.74	$223.74	$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 $177.18 / $177.18 / $177.18	Facility	TC	$177.18	$177.18	$177.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.09 / $86.60 / $120.23	Professional		$39.09	$86.60	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $18.39 / $23.27	Professional	26	$9.77	$18.39	$23.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.40 / $68.19 / $96.96	Professional	TC	$30.40	$68.19	$96.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.70 / $183.28 / $381.55	Facility		$44.70	$183.28	$381.55
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 $149.85 / $283.92 / $394.56	Facility	TC	$149.85	$283.92	$394.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.03 / $69.92 / $263.06	Professional		$43.03	$69.92	$263.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.24 / $16.26 / $24.51	Professional	26	$10.24	$16.26	$24.51
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.79 / $53.29 / $209.88	Professional	TC	$32.79	$53.29	$209.88
Midlands Facility/Professional Facility Modifier Low / Median / High Price $62.08 / $86.60 / $122.64	Facility		$62.08	$86.60	$122.64
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $26.94 / $27.73 / $46.62	Facility	26	$26.94	$27.73	$46.62
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $58.34 / $94.91 / $177.18	Facility	TC	$58.34	$94.91	$177.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $52.00 / $80.20 / $103.62	Professional		$52.00	$80.20	$103.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.64 / $36.57 / $71.33	Professional		$8.64	$36.57	$71.33
United Facility/Professional Professional Modifier Low / Median / High Price $43.03 / $69.92 / $87.96	Professional		$43.03	$69.92	$87.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.24 / $16.26 / $21.33	Professional	26	$10.24	$16.26	$21.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.79 / $52.66 / $67.04	Professional	TC	$32.79	$52.66	$67.04