Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.16 / $154.91 / $562.58	Facility	26	$62.16	$154.91	$562.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.02 / $226.91 / $917.81	Professional		$140.02	$226.91	$917.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.17 / $144.36 / $288.72	Professional	26	$61.17	$144.36	$288.72
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $98.78 / $98.78 / $665.13	Professional	52	$98.78	$98.78	$665.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $135.38 / $335.00 / $917.81	Professional	TC	$135.38	$335.00	$917.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $148.59 / $208.03 / $452.57	Professional		$148.59	$208.03	$452.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.18 / $115.23 / $153.69	Professional	26	$66.18	$115.23	$153.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $101.32 / $101.32 / $253.30	Professional	TC	$101.32	$101.32	$253.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $361.07 / $385.95 / $408.93	Professional		$361.07	$385.95	$408.93
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.38 / $121.20 / $128.66	Professional	26	$113.38	$121.20	$128.66
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $247.68 / $264.74 / $280.25	Professional	TC	$247.68	$264.74	$280.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $357.66 / $357.66 / $357.66	Facility	26	$357.66	$357.66	$357.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $262.08 / $461.20 / $701.93	Professional		$262.08	$461.20	$701.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.92 / $142.22 / $182.29	Professional	26	$81.92	$142.22	$182.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $180.16 / $316.63 / $538.16	Professional	TC	$180.16	$316.63	$538.16
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $603.28 / $603.28 / $603.28	Facility	26	$603.28	$603.28	$603.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $321.60 / $521.21 / $2,789.74	Professional		$321.60	$521.21	$2,789.74
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $79.90 / $131.75 / $542.85	Professional	26	$79.90	$131.75	$542.85
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $221.73 / $369.55 / $2,451.15	Professional	TC	$221.73	$369.55	$2,451.15
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $212.90 / $219.10 / $357.66	Facility	26	$212.90	$219.10	$357.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $391.05 / $506.00 / $871.00	Professional		$391.05	$506.00	$871.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.44 / $190.21 / $339.52	Professional		$64.44	$190.21	$339.52
United Facility/Professional Professional Modifier Low / Median / High Price $257.27 / $471.68 / $680.16	Professional		$257.27	$471.68	$680.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.29 / $129.83 / $166.45	Professional	26	$77.29	$129.83	$166.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.38 / $325.20 / $489.02	Professional	TC	$177.38	$325.20	$489.02