Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $22.91 / $87.10	Facility	26	$14.45	$22.91	$87.10
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $56.23 / $154.88 / $467.74	Facility	TC	$56.23	$154.88	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $52.48 / $169.82	Professional		$21.38	$52.48	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $21.88 / $52.48	Professional	26	$10.23	$21.88	$52.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $45.71 / $87.10 / $251.19	Professional	50	$45.71	$87.10	$251.19
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $43.65 / $43.65 / $43.65	Professional	52	$43.65	$43.65	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $54.95 / $131.83	Professional	TC	$30.20	$54.95	$131.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.90 / $91.20	Professional		$30.90	$38.90	$91.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $15.85 / $24.55	Professional	26	$8.51	$15.85	$24.55
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $61.66 / $154.88	Professional	50	$52.48	$61.66	$154.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $44.67 / $81.28	Professional	TC	$28.84	$44.67	$81.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $85.11 / $89.13	Professional		$77.62	$85.11	$89.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $20.89 / $21.38	Professional	26	$19.50	$20.89	$21.38
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $64.57 / $67.61	Professional	TC	$58.88	$64.57	$67.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $61.66 / $61.66	Facility	26	$61.66	$61.66	$61.66
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $194.98 / $194.98 / $194.98	Facility	TC	$194.98	$194.98	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $89.13 / $141.25	Professional		$36.31	$89.13	$141.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $22.91 / $31.62	Professional	26	$9.77	$22.91	$31.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $66.07 / $109.65	Professional	TC	$27.54	$66.07	$109.65
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $100.00 / $100.00	Facility	26	$26.30	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $165.96 / $338.84 / $549.54	Facility	TC	$165.96	$338.84	$549.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $69.18 / $295.12	Professional		$42.66	$69.18	$295.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $20.89 / $32.36	Professional	26	$13.18	$20.89	$32.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $48.98 / $229.09	Professional	TC	$29.51	$48.98	$229.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $97.72 / $162.18	Professional		$89.13	$97.72	$162.18
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $23.99 / $37.15	Professional	26	$21.38	$23.99	$37.15
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $74.13 / $123.03	Professional	TC	$66.07	$74.13	$123.03
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $61.66 / $61.66	Facility	26	$61.66	$61.66	$61.66
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $64.57 / $194.98 / $194.98	Facility	TC	$64.57	$194.98	$194.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $64.57 / $162.18	Professional		$63.10	$64.57	$162.18
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $21.88 / $37.15	Professional	26	$18.20	$21.88	$37.15
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $44.67 / $123.03	Professional	TC	$41.69	$44.67	$123.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $39.81 / $85.11	Professional		$11.48	$39.81	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $60.26 / $100.00	Professional		$42.66	$60.26	$100.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $17.38 / $27.54	Professional	26	$11.48	$17.38	$27.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $44.67 / $74.13	Professional	TC	$29.51	$44.67	$74.13