Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.40 / $14.46 / $47.00	Facility	26	$14.40	$14.46	$47.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.86 / $83.40 / $300.00	Professional		$54.86	$83.40	$300.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.40 / $30.06 / $66.40	Professional	26	$14.40	$30.06	$66.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.11 / $43.41 / $174.40	Professional	TC	$37.11	$43.41	$174.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $135.01 / $135.01 / $141.37	Professional		$135.01	$135.01	$141.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.58 / $20.67 / $28.52	Professional	26	$14.58	$20.67	$28.52
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $83.24 / $83.24 / $83.24	Professional	TC	$83.24	$83.24	$83.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.69 / $114.04 / $116.89	Professional		$106.69	$114.04	$116.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.53 / $28.35 / $29.80	Professional	26	$26.53	$28.35	$29.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.15 / $85.68 / $87.81	Professional	TC	$80.15	$85.68	$87.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.70 / $83.70 / $83.70	Facility	26	$83.70	$83.70	$83.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.78 / $130.81 / $182.29	Professional		$59.78	$130.81	$182.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.68 / $32.88 / $42.66	Professional	26	$17.68	$32.88	$42.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.34 / $97.93 / $139.63	Professional	TC	$46.34	$97.93	$139.63
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 Professional Modifier Low / Median / High Price $66.02 / $107.29 / $395.03	Professional		$66.02	$107.29	$395.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.66 / $30.24 / $93.99	Professional	26	$18.66	$30.24	$93.99
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $47.36 / $76.97 / $301.02	Professional	TC	$47.36	$76.97	$301.02
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $66.00 / $67.92 / $83.70	Facility	26	$66.00	$67.92	$83.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $108.36 / $130.81 / $163.02	Professional		$108.36	$130.81	$163.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.37 / $55.36 / $102.87	Professional		$15.37	$55.36	$102.87
United Facility/Professional Professional Modifier Low / Median / High Price $66.02 / $107.29 / $134.96	Professional		$66.02	$107.29	$134.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.66 / $29.96 / $38.14	Professional	26	$18.66	$29.96	$38.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.36 / $76.97 / $96.82	Professional	TC	$47.36	$76.97	$96.82