Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.95 / $136.16 / $423.82	Facility		$44.95	$136.16	$423.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.71 / $24.88 / $69.15	Facility	26	$7.71	$24.88	$69.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.97 / $79.38 / $270.63	Facility	TC	$22.97	$79.38	$270.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.07 / $44.40 / $174.26	Professional		$19.07	$44.40	$174.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.48 / $19.22 / $46.55	Professional	26	$7.48	$19.22	$46.55
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.36 / $56.00 / $116.00	Professional	50	$15.36	$56.00	$116.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.56 / $28.62 / $174.20	Professional	52	$14.56	$28.62	$174.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.93 / $28.62 / $126.46	Professional	TC	$19.93	$28.62	$126.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.33 / $22.33 / $22.33	Professional		$22.33	$22.33	$22.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.95 / $14.33 / $26.86	Professional	26	$5.95	$14.33	$26.86
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 $54.32 / $58.06 / $59.50	Professional		$54.32	$58.06	$59.50
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 $38.54 / $42.88 / $44.00	Professional	TC	$38.54	$42.88	$44.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $171.36 / $171.36 / $600.00	Facility		$171.36	$171.36	$600.00
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 $126.72 / $126.72 / $126.72	Facility	TC	$126.72	$126.72	$126.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.61 / $65.98 / $91.14	Professional		$30.61	$65.98	$91.14
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 $22.63 / $48.36 / $68.84	Professional	TC	$22.63	$48.36	$68.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.12 / $54.77 / $342.77	Facility		$29.12	$54.77	$342.77
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 $105.96 / $105.96 / $268.77	Facility	TC	$105.96	$105.96	$268.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.54 / $54.50 / $200.17	Professional		$33.54	$54.50	$200.17
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $15.73 / $61.09	Professional	26	$9.80	$15.73	$61.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.74 / $38.57 / $154.00	Professional	TC	$23.74	$38.57	$154.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $65.98 / $93.64	Facility		$50.00	$65.98	$93.64
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $25.76 / $26.51 / $44.64	Facility	26	$25.76	$26.51	$44.64
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $41.12 / $64.95 / $126.72	Facility	TC	$41.12	$64.95	$126.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $61.48 / $78.06	Professional		$46.00	$61.48	$78.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.18 / $27.92 / $52.76	Professional		$8.18	$27.92	$52.76
United Facility/Professional Facility Modifier Low / Median / High Price $110.06 / $197.98 / $277.98	Facility		$110.06	$197.98	$277.98
United Facility/Professional Professional Modifier Low / Median / High Price $33.09 / $54.08 / $68.56	Professional		$33.09	$54.08	$68.56
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 $22.02 / $38.11 / $48.52	Professional	TC	$22.02	$38.11	$48.52