Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.67 / $11.66 / $27.70	Facility	26	$8.67	$11.66	$27.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.06 / $29.67 / $54.33	Facility	TC	$22.06	$29.67	$54.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.67 / $30.72 / $117.46	Professional		$8.67	$30.72	$117.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $17.48 / $40.79	Professional	26	$8.52	$17.48	$40.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $22.06 / $54.87	Professional	TC	$18.32	$22.06	$54.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.50 / $59.50 / $59.50	Professional		$59.50	$59.50	$59.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.28 / $12.44 / $21.49	Professional	26	$9.28	$12.44	$21.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.71 / $60.61 / $62.14	Professional		$56.71	$60.61	$62.14
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.96 / $17.05 / $17.94	Professional	26	$15.96	$17.05	$17.94
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $43.53 / $44.63	Professional	TC	$40.74	$43.53	$44.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.40 / $50.40 / $50.40	Facility	26	$50.40	$50.40	$50.40
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $128.52 / $128.52 / $128.52	Facility	TC	$128.52	$128.52	$128.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.10 / $68.95 / $96.96	Professional		$32.10	$68.95	$96.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.54 / $19.91 / $25.21	Professional	26	$10.54	$19.91	$25.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.40 / $49.05 / $71.75	Professional	TC	$23.40	$49.05	$71.75
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.00 / $70.00 / $70.00	Facility	26	$70.00	$70.00	$70.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $110.49 / $110.49 / $110.49	Facility	TC	$110.49	$110.49	$110.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.20 / $57.19 / $208.77	Professional		$35.20	$57.19	$208.77
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $17.61 / $57.45	Professional	26	$11.07	$17.61	$57.45
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.50 / $39.21 / $151.32	Professional	TC	$23.50	$39.21	$151.32
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $38.77 / $39.90 / $50.40	Facility	26	$38.77	$39.90	$50.40
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $42.90 / $82.68 / $128.52	Facility	TC	$42.90	$82.68	$128.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $56.81 / $68.95 / $85.61	Professional		$56.81	$68.95	$85.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.16 / $29.74 / $56.69	Professional		$9.16	$29.74	$56.69
United Facility/Professional Professional Modifier Low / Median / High Price $35.20 / $57.19 / $73.33	Professional		$35.20	$57.19	$73.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $17.77 / $22.62	Professional	26	$11.07	$17.77	$22.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.13 / $40.96 / $49.33	Professional	TC	$24.13	$40.96	$49.33