Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $83.18 / $245.47	Facility	26	$45.71	$83.18	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $117.49 / $245.47	Professional		$89.13	$117.49	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $28.18 / $69.18	Professional	26	$22.91	$28.18	$69.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $91.20 / $181.97	Professional	TC	$66.07	$91.20	$181.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $32.36 / $50.12	Professional	26	$30.90	$32.36	$50.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $229.09 / $245.47	Professional		$213.80	$229.09	$245.47
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $51.29 / $54.95	Professional	26	$48.98	$51.29	$54.95
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $177.83 / $190.55	Professional	TC	$154.88	$177.83	$190.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.88 / $154.88 / $154.88	Facility	26	$154.88	$154.88	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $239.88 / $371.54	Professional		$95.50	$239.88	$371.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $53.70 / $81.28	Professional	26	$25.12	$53.70	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $181.97 / $295.12	Professional	TC	$75.86	$181.97	$295.12
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	26	$125.89	$125.89	$125.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $177.83 / $870.96	Professional		$112.20	$177.83	$870.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $47.86 / $199.53	Professional	26	$32.36	$47.86	$199.53
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $128.82 / $691.83	Professional	TC	$81.28	$128.82	$691.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $269.15 / $426.58	Professional		$245.47	$269.15	$426.58
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $60.26 / $93.33	Professional	26	$53.70	$60.26	$93.33
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $208.93 / $331.13	Professional	TC	$181.97	$208.93	$331.13
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $154.88 / $154.88 / $154.88	Facility	26	$154.88	$154.88	$154.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $194.98 / $426.58	Professional		$181.97	$194.98	$426.58
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $52.48 / $93.33	Professional	26	$44.67	$52.48	$93.33
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $141.25 / $331.13	Professional	TC	$134.90	$141.25	$331.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $107.15 / $229.09	Professional		$29.51	$107.15	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $169.82 / $275.42	Professional		$112.20	$169.82	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $44.67 / $70.79	Professional	26	$29.51	$44.67	$70.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $123.03 / $204.17	Professional	TC	$81.28	$123.03	$204.17