Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.76 / $26.40 / $95.16	Facility	26	$12.76	$26.40	$95.16
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $41.11 / $186.06 / $696.78	Facility	TC	$41.11	$186.06	$696.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.13 / $57.74 / $174.52	Professional		$22.13	$57.74	$174.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.64 / $25.28 / $54.24	Professional	26	$10.64	$25.28	$54.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $87.08 / $155.52 / $292.00	Professional	50	$87.08	$155.52	$292.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $21.32 / $21.77 / $126.57	Professional	52	$21.32	$21.77	$126.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.54 / $56.66 / $159.00	Professional	TC	$30.54	$56.66	$159.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.97 / $103.09 / $106.24	Professional		$35.97	$103.09	$106.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.40 / $19.85 / $24.80	Professional	26	$11.40	$19.85	$24.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.71 / $25.71 / $64.26	Professional	TC	$25.71	$25.71	$64.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.45 / $87.06 / $89.26	Professional		$81.45	$87.06	$89.26
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.60 / $20.96 / $21.57	Professional	26	$19.60	$20.96	$21.57
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $59.54 / $65.78 / $67.79	Professional	TC	$59.54	$65.78	$67.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.86 / $61.86 / $61.86	Facility	26	$61.86	$61.86	$61.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $195.18 / $195.18 / $195.18	Facility	TC	$195.18	$195.18	$195.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.24 / $98.28 / $138.66	Professional		$44.24	$98.28	$138.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $23.72 / $31.03	Professional	26	$12.80	$23.72	$31.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $74.56 / $107.63	Professional	TC	$33.11	$74.56	$107.63
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.13 / $100.00 / $100.00	Facility	26	$26.13	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $165.02 / $254.40 / $552.00	Facility	TC	$165.02	$254.40	$552.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.74 / $79.20 / $297.63	Professional		$48.74	$79.20	$297.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $21.43 / $87.52	Professional	26	$13.19	$21.43	$87.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $35.54 / $57.78 / $229.42	Professional	TC	$35.54	$57.78	$229.42
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $37.70 / $38.79 / $61.86	Facility	26	$37.70	$38.79	$61.86
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $64.26 / $105.86 / $195.18	Facility	TC	$64.26	$105.86	$195.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $63.00 / $91.42 / $116.89	Professional		$63.00	$91.42	$116.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.43 / $42.82 / $82.43	Professional		$11.43	$42.82	$82.43
United Facility/Professional Professional Modifier Low / Median / High Price $48.74 / $78.28 / $99.64	Professional		$48.74	$78.28	$99.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $21.23 / $26.96	Professional	26	$13.19	$21.23	$26.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.54 / $57.78 / $72.68	Professional	TC	$35.54	$57.78	$72.68