Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.97 / $245.40 / $469.04	Facility		$49.97	$245.40	$469.04
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.33 / $17.57 / $32.97	Facility	26	$10.33	$17.57	$32.97
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $44.86 / $267.64 / $490.55	Facility	TC	$44.86	$267.64	$490.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.10 / $44.07 / $136.80	Professional		$11.10	$44.07	$136.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.05 / $21.08 / $52.02	Professional	26	$10.05	$21.08	$52.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $26.39 / $26.39 / $157.91	Professional	50	$26.39	$26.39	$157.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.11 / $61.69 / $166.00	Professional	TC	$31.11	$61.69	$166.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.26 / $47.72 / $103.82	Professional		$35.26	$47.72	$103.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $14.23 / $24.07	Professional	26	$7.95	$14.23	$24.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.18 / $31.42 / $67.75	Professional	TC	$26.18	$31.42	$67.75
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 $82.04 / $87.68 / $89.89	Professional		$82.04	$87.68	$89.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.03 / $20.34 / $21.37	Professional	26	$19.03	$20.34	$21.37
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.93 / $67.01 / $69.04	Professional	TC	$61.93	$67.01	$69.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $258.77 / $258.77 / $326.00	Facility		$258.77	$258.77	$326.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.06 / $60.06 / $60.06	Facility	26	$60.06	$60.06	$60.06
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $198.78 / $198.78 / $198.78	Facility	TC	$198.78	$198.78	$198.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.16 / $99.72 / $139.63	Professional		$48.16	$99.72	$139.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.42 / $23.75 / $30.06	Professional	26	$12.42	$23.75	$30.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.68 / $75.95 / $109.57	Professional	TC	$34.68	$75.95	$109.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $56.61 / $146.68 / $379.20	Facility		$56.61	$146.68	$379.20
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.13 / $70.00 / $70.00	Facility	26	$26.13	$70.00	$70.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $168.01 / $323.95 / $451.25	Facility	TC	$168.01	$323.95	$451.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.44 / $81.76 / $301.95	Professional		$49.44	$81.76	$301.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $20.62 / $31.56	Professional	26	$13.19	$20.62	$31.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $35.40 / $60.33 / $233.75	Professional	TC	$35.40	$60.33	$233.75
Midlands Facility/Professional Facility Modifier Low / Median / High Price $79.27 / $99.72 / $166.43	Facility		$79.27	$99.72	$166.43
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $45.94 / $47.28 / $60.06	Facility	26	$45.94	$47.28	$60.06
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $65.45 / $124.01 / $198.78	Facility	TC	$65.45	$124.01	$198.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $79.27 / $98.10 / $123.84	Professional		$79.27	$98.10	$123.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.80 / $42.56 / $81.34	Professional		$10.80	$42.56	$81.34
United Facility/Professional Professional Modifier Low / Median / High Price $50.32 / $81.76 / $102.85	Professional		$50.32	$81.76	$102.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $20.94 / $26.96	Professional	26	$13.19	$20.94	$26.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.13 / $59.62 / $75.89	Professional	TC	$37.13	$59.62	$75.89