Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $338.84 / $630.96	Facility		$41.69	$338.84	$630.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $22.91 / $33.88	Facility	26	$13.80	$22.91	$33.88
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $48.98 / $100.00 / $660.69	Facility	TC	$48.98	$100.00	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $52.48 / $154.88	Professional		$34.67	$52.48	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $18.62 / $44.67	Professional	26	$10.00	$18.62	$44.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $26.92 / $26.92 / $147.91	Professional	50	$26.92	$26.92	$147.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.88 / $70.79	Professional	TC	$25.70	$33.88	$70.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $30.90 / $74.13	Professional		$26.30	$30.90	$74.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.96 / $22.91	Professional	26	$7.94	$10.96	$22.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $26.92 / $70.79	Professional	TC	$18.62	$26.92	$70.79
BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $213.80 / $416.87	Facility		$147.91	$213.80	$416.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $74.13 / $77.62	Professional		$70.79	$74.13	$77.62
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $19.95 / $21.38	Professional	26	$19.05	$19.95	$21.38
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $53.70 / $57.54	Professional	TC	$51.29	$53.70	$57.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $60.26 / $60.26	Facility	26	$60.26	$60.26	$60.26
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	TC	$165.96	$165.96	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $77.62 / $123.03	Professional		$31.62	$77.62	$123.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $22.91 / $30.90	Professional	26	$8.71	$22.91	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $57.54 / $93.33	Professional	TC	$23.44	$57.54	$93.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $123.03 / $575.44	Facility		$38.90	$123.03	$575.44
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 $138.04 / $138.04 / $138.04	Facility	TC	$138.04	$138.04	$138.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $66.07 / $263.03	Professional		$44.67	$66.07	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $19.05 / $32.36	Professional	26	$13.18	$19.05	$32.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $42.66 / $194.98	Professional	TC	$30.90	$42.66	$194.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $87.10 / $141.25	Professional		$77.62	$87.10	$141.25
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $23.99 / $36.31	Professional	26	$20.89	$23.99	$36.31
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $64.57 / $104.71	Professional	TC	$57.54	$64.57	$104.71
Midlands Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $60.26 / $60.26	Facility	26	$60.26	$60.26	$60.26
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $53.70 / $165.96 / $165.96	Facility	TC	$53.70	$165.96	$165.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $91.20 / $141.25	Professional		$77.62	$91.20	$141.25
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $23.99 / $36.31	Professional	26	$20.89	$23.99	$36.31
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $67.61 / $104.71	Professional	TC	$57.54	$67.61	$104.71
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Facility		$331.13	$331.13	$331.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $32.36 / $70.79	Professional		$10.96	$32.36	$70.79
United Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $109.65 / $275.42	Facility		$12.88	$109.65	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $58.88 / $91.20	Professional		$40.74	$58.88	$91.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $17.38 / $27.54	Professional	26	$11.75	$17.38	$27.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $41.69 / $64.57	Professional	TC	$28.84	$41.69	$64.57