Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $46.77 / $46.77	Facility	26	$14.45	$46.77	$46.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $69.18 / $186.21	Professional		$51.29	$69.18	$186.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $26.30 / $38.02	Professional	26	$14.13	$26.30	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $43.65 / $107.15	Professional	TC	$36.31	$43.65	$107.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $50.12 / $141.25	Professional		$37.15	$50.12	$141.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $16.22 / $28.84	Professional	26	$11.22	$16.22	$28.84
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $30.90 / $83.18	Professional	TC	$29.51	$30.90	$83.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $112.20 / $117.49	Professional		$104.71	$112.20	$117.49
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $28.18 / $29.51	Professional	26	$26.30	$28.18	$29.51
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $83.18 / $87.10	Professional	TC	$77.62	$83.18	$87.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $83.18 / $83.18	Facility	26	$83.18	$83.18	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $117.49 / $186.21	Professional		$47.86	$117.49	$186.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $31.62 / $43.65	Professional	26	$12.02	$31.62	$43.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $87.10 / $141.25	Professional	TC	$35.48	$87.10	$141.25
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 Professional Modifier Low / Median / High Price $64.57 / $89.13 / $398.11	Professional		$64.57	$89.13	$398.11
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $28.18 / $93.33	Professional	26	$18.62	$28.18	$93.33
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $63.10 / $302.00	Professional	TC	$46.77	$63.10	$302.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $131.83 / $208.93	Professional		$117.49	$131.83	$208.93
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $33.11 / $51.29	Professional	26	$28.84	$33.11	$51.29
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $97.72 / $158.49	Professional	TC	$87.10	$97.72	$158.49
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $83.18 / $83.18	Facility	26	$83.18	$83.18	$83.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $138.04 / $208.93	Professional		$117.49	$138.04	$208.93
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $33.88 / $51.29	Professional	26	$28.84	$33.88	$51.29
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $104.71 / $158.49	Professional	TC	$87.10	$104.71	$158.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $47.86 / $104.71	Professional		$15.49	$47.86	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $87.10 / $138.04	Professional		$58.88	$87.10	$138.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $24.55 / $38.90	Professional	26	$16.60	$24.55	$38.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $61.66 / $97.72	Professional	TC	$42.66	$61.66	$97.72