Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.42 / $20.30 / $57.28	Facility	26	$6.42	$20.30	$57.28
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $42.19 / $156.04 / $272.58	Facility	TC	$42.19	$156.04	$272.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.80 / $46.05 / $132.90	Professional		$14.80	$46.05	$132.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.32 / $14.74 / $33.00	Professional	26	$6.32	$14.74	$33.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $31.50 / $31.50 / $31.50	Professional	50	$31.50	$31.50	$31.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.23 / $17.61 / $102.92	Professional	52	$17.23	$17.61	$102.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.57 / $49.53 / $134.00	Professional	TC	$25.57	$49.53	$134.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.12 / $73.00 / $73.00	Professional		$68.12	$73.00	$73.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.81 / $11.25 / $14.81	Professional	26	$6.81	$11.25	$14.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.81 / $35.81 / $57.92	Professional	TC	$35.81	$35.81	$57.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.34 / $70.09 / $71.84	Professional		$65.34	$70.09	$71.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.71 / $12.52 / $13.14	Professional	26	$11.71	$12.52	$13.14
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.68 / $57.57 / $59.02	Professional	TC	$51.68	$57.57	$59.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.96 / $36.96 / $36.96	Facility	26	$36.96	$36.96	$36.96
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $169.92 / $169.92 / $169.92	Facility	TC	$169.92	$169.92	$169.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.65 / $79.22 / $111.51	Professional		$37.65	$79.22	$111.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $14.58 / $18.42	Professional	26	$7.90	$14.58	$18.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.13 / $64.64 / $93.08	Professional	TC	$28.13	$64.64	$93.08
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 $143.82 / $198.55 / $336.00	Facility	TC	$143.82	$198.55	$336.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.00 / $63.92 / $241.48	Professional		$34.00	$63.92	$241.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $12.67 / $51.19	Professional	26	$8.11	$12.67	$51.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.22 / $50.74 / $199.06	Professional	TC	$31.22	$50.74	$199.06
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $21.37 / $22.00 / $36.96	Facility	26	$21.37	$22.00	$36.96
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $55.96 / $85.63 / $169.92	Facility	TC	$55.96	$85.63	$169.92
Midlands Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $71.88 / $95.32	Professional		$41.00	$71.88	$95.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $6.86 / $34.03 / $65.69	Professional		$6.86	$34.03	$65.69
United Facility/Professional Professional Modifier Low / Median / High Price $37.95 / $63.92 / $81.95	Professional		$37.95	$63.92	$81.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $13.03 / $16.57	Professional	26	$8.11	$13.03	$16.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.22 / $50.74 / $63.83	Professional	TC	$31.22	$50.74	$63.83