Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.83 / $250.17 / $424.98	Facility		$54.83	$250.17	$424.98
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.71 / $21.06 / $76.09	Facility	26	$7.71	$21.06	$76.09
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.57 / $233.28 / $515.29	Facility	TC	$32.57	$233.28	$515.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.47 / $37.96 / $118.41	Professional		$8.47	$37.96	$118.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.44 / $17.21 / $42.00	Professional	26	$7.44	$17.21	$42.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.36 / $114.00 / $208.50	Professional	50	$15.36	$114.00	$208.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.42 / $15.95 / $96.53	Professional	52	$15.42	$15.95	$96.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.51 / $41.82 / $109.00	Professional	TC	$22.51	$41.82	$109.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.23 / $25.74 / $60.58	Professional		$24.23	$25.74	$60.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.11 / $14.33 / $20.39	Professional	26	$6.11	$14.33	$20.39
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $41.24 / $41.24 / $82.00	Professional	50	$41.24	$41.24	$82.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $47.49 / $47.49 / $47.49	Professional	TC	$47.49	$47.49	$47.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.78 / $198.92 / $373.43	Facility		$146.78	$198.92	$373.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.89 / $62.93 / $64.51	Professional		$58.89	$62.93	$64.51
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.15 / $15.11 / $15.90	Professional	26	$14.15	$15.11	$15.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.74 / $47.82 / $49.02	Professional	TC	$44.74	$47.82	$49.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $185.76 / $185.76 / $326.00	Facility		$185.76	$185.76	$326.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.64 / $44.64 / $44.64	Facility	26	$44.64	$44.64	$44.64
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $141.12 / $141.12 / $141.12	Facility	TC	$141.12	$141.12	$141.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.77 / $72.34 / $98.90	Professional		$33.77	$72.34	$98.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $17.63 / $22.30	Professional	26	$9.41	$17.63	$22.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.12 / $54.71 / $76.59	Professional	TC	$26.12	$54.71	$76.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.19 / $89.90 / $361.90	Facility		$42.19	$89.90	$361.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $118.08 / $221.13 / $568.75	Facility	TC	$118.08	$221.13	$568.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.09 / $60.27 / $219.71	Professional		$37.09	$60.27	$219.71
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.83 / $15.65 / $29.19	Professional	26	$9.83	$15.65	$29.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.29 / $44.34 / $168.70	Professional	TC	$27.29	$44.34	$168.70
Midlands Facility/Professional Facility Modifier Low / Median / High Price $58.71 / $72.34 / $111.76	Facility		$58.71	$72.34	$111.76
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $30.24 / $31.12 / $44.64	Facility	26	$30.24	$31.12	$44.64
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $45.88 / $71.51 / $141.12	Facility	TC	$45.88	$71.51	$141.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $49.00 / $66.63 / $91.06	Professional		$49.00	$66.63	$91.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.18 / $30.28 / $57.67	Professional		$8.18	$30.28	$57.67
United Facility/Professional Facility Modifier Low / Median / High Price $81.70 / $163.63 / $206.53	Facility		$81.70	$163.63	$206.53
United Facility/Professional Professional Modifier Low / Median / High Price $37.09 / $50.86 / $75.81	Professional		$37.09	$50.86	$75.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $15.74 / $20.43	Professional	26	$9.80	$15.74	$20.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.16 / $43.82 / $55.78	Professional	TC	$22.16	$43.82	$55.78