Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.54 / $13.63 / $43.87	Facility	26	$13.54	$13.63	$43.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $36.60 / $39.21 / $91.59	Facility	TC	$36.60	$39.21	$91.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.70 / $59.05 / $280.00	Professional		$46.70	$59.05	$280.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.63 / $28.29 / $36.08	Professional	26	$13.63	$28.29	$36.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $76.55 / $76.55 / $99.21	Professional	50	$76.55	$76.55	$99.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.85 / $36.60 / $204.00	Professional	TC	$30.85	$36.60	$204.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.34 / $42.34 / $42.34	Professional		$42.34	$42.34	$42.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.60 / $26.08 / $31.77	Professional	26	$14.60	$26.08	$31.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.26 / $99.68 / $102.17	Professional		$93.26	$99.68	$102.17
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.10 / $26.84 / $28.21	Professional	26	$25.10	$26.84	$28.21
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.15 / $72.84 / $74.68	Professional	TC	$68.15	$72.84	$74.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.20 / $79.20 / $79.20	Facility	26	$79.20	$79.20	$79.20
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $214.98 / $214.98 / $214.98	Facility	TC	$214.98	$214.98	$214.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.65 / $114.36 / $158.05	Professional		$52.65	$114.36	$158.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.18 / $31.32 / $39.75	Professional	26	$16.18	$31.32	$39.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.18 / $83.04 / $118.29	Professional	TC	$38.18	$83.04	$118.29
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 $181.68 / $181.68 / $665.28	Facility	TC	$181.68	$181.68	$665.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.07 / $94.37 / $345.18	Professional		$58.07	$94.37	$345.18
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $28.28 / $89.67	Professional	26	$17.39	$28.28	$89.67
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $39.64 / $66.09 / $255.46	Professional	TC	$39.64	$66.09	$255.46
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $61.73 / $63.53 / $79.20	Facility	26	$61.73	$63.53	$79.20
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $70.80 / $138.76 / $214.98	Facility	TC	$70.80	$138.76	$214.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.42 / $114.22 / $142.06	Professional		$93.42	$114.22	$142.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.39 / $48.36 / $91.34	Professional		$14.39	$48.36	$91.34
United Facility/Professional Professional Modifier Low / Median / High Price $58.07 / $94.37 / $120.98	Professional		$58.07	$94.37	$120.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $27.62 / $35.57	Professional	26	$17.39	$27.62	$35.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.67 / $65.31 / $83.13	Professional	TC	$40.67	$65.31	$83.13