Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.90 / $337.57 / $623.91	Facility		$41.90	$337.57	$623.91
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.30 / $13.89 / $33.97	Facility	26	$10.30	$13.89	$33.97
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.25 / $75.91 / $660.48	Facility	TC	$28.25	$75.91	$660.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.26 / $61.24 / $163.12	Professional		$38.26	$61.24	$163.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.33 / $20.22 / $46.82	Professional	26	$10.33	$20.22	$46.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $27.18 / $27.18 / $146.63	Professional	50	$27.18	$27.18	$146.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.48 / $46.84 / $67.18	Professional	TC	$27.48	$46.84	$67.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.43 / $90.08 / $90.08	Professional		$31.43	$90.08	$90.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $18.28 / $24.07	Professional	26	$11.07	$18.28	$24.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $56.08 / $56.08 / $56.08	Professional	TC	$56.08	$56.08	$56.08
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 $71.18 / $76.09 / $78.00	Professional		$71.18	$76.09	$78.00
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 $52.15 / $55.75 / $57.14	Professional	TC	$52.15	$55.75	$57.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $224.58 / $224.58 / $224.58	Facility		$224.58	$224.58	$224.58
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 $164.52 / $164.52 / $164.52	Facility	TC	$164.52	$164.52	$164.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.38 / $87.65 / $120.23	Professional		$40.38	$87.65	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.42 / $23.72 / $30.06	Professional	26	$12.42	$23.72	$30.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.62 / $63.92 / $90.18	Professional	TC	$29.62	$63.92	$90.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.58 / $81.58 / $504.96	Facility		$38.58	$81.58	$504.96
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 $139.28 / $139.28 / $139.28	Facility	TC	$139.28	$139.28	$139.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.41 / $72.17 / $265.10	Professional		$44.41	$72.17	$265.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $20.95 / $68.20	Professional	26	$13.19	$20.95	$68.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.22 / $50.74 / $196.89	Professional	TC	$31.22	$50.74	$196.89
Midlands Facility/Professional Facility Modifier Low / Median / High Price $75.91 / $87.65 / $159.25	Facility		$75.91	$87.65	$159.25
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $47.37 / $48.75 / $60.06	Facility	26	$47.37	$48.75	$60.06
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $54.18 / $115.14 / $164.52	Facility	TC	$54.18	$115.14	$164.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $73.56 / $87.65 / $109.28	Professional		$73.56	$87.65	$109.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.80 / $36.94 / $69.90	Professional		$10.80	$36.94	$69.90
United Facility/Professional Professional Modifier Low / Median / High Price $44.41 / $72.17 / $90.79	Professional		$44.41	$72.17	$90.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $21.18 / $26.96	Professional	26	$13.19	$21.18	$26.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.22 / $56.36 / $63.83	Professional	TC	$31.22	$56.36	$63.83