Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $27.54 / $27.54	Facility	26	$11.22	$27.54	$27.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.84 / $69.18 / $165.96	Facility	TC	$28.84	$69.18	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $34.67 / $91.20	Professional		$8.91	$34.67	$91.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $37.15	Professional	26	$7.94	$12.02	$37.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $21.88 / $57.54	Professional	TC	$18.20	$21.88	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $25.70 / $37.15	Professional		$21.88	$25.70	$37.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.47 / $16.60	Professional	26	$6.92	$10.47	$16.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $26.92 / $26.92	Professional	TC	$26.92	$26.92	$26.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $58.88 / $61.66	Professional		$54.95	$58.88	$61.66
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $16.98 / $17.78	Professional	26	$15.85	$16.98	$17.78
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $42.66 / $44.67	Professional	TC	$38.90	$42.66	$44.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $50.12 / $50.12	Facility	26	$50.12	$50.12	$50.12
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	TC	$128.82	$128.82	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $61.66 / $100.00	Professional		$25.70	$61.66	$100.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $19.05 / $25.70	Professional	26	$7.24	$19.05	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $44.67 / $74.13	Professional	TC	$18.20	$44.67	$74.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	TC	$109.65	$109.65	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $46.77 / $208.93	Professional		$33.88	$46.77	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.22 / $26.30	Professional	26	$10.96	$16.22	$26.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $32.36 / $151.36	Professional	TC	$23.44	$32.36	$151.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $69.18 / $112.20	Professional		$61.66	$69.18	$112.20
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $19.95 / $30.90	Professional	26	$17.38	$19.95	$30.90
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $48.98 / $83.18	Professional	TC	$44.67	$48.98	$83.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $50.12 / $50.12	Facility	26	$50.12	$50.12	$50.12
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $42.66 / $128.82 / $128.82	Facility	TC	$42.66	$128.82	$128.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $74.13 / $112.20	Professional		$61.66	$74.13	$112.20
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $20.42 / $30.90	Professional	26	$17.38	$20.42	$30.90
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $53.70 / $83.18	Professional	TC	$44.67	$53.70	$83.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $25.70 / $57.54	Professional		$9.33	$25.70	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $45.71 / $72.44	Professional		$30.90	$45.71	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $14.45 / $22.91	Professional	26	$9.77	$14.45	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $30.20 / $50.12	Professional	TC	$21.38	$30.20	$50.12