Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $25.70 / $79.43	Facility	26	$14.13	$25.70	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $47.86 / $147.91	Professional		$30.20	$47.86	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.79 / $25.12	Professional	26	$7.08	$14.79	$25.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $239.88 / $239.88 / $239.88	Professional	50	$239.88	$239.88	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $34.67 / $72.44	Professional	TC	$22.39	$34.67	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $31.62 / $47.86	Professional		$29.51	$31.62	$47.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $7.94 / $9.55	Professional	26	$6.61	$7.94	$9.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $47.86 / $67.61	Professional	TC	$17.78	$47.86	$67.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $70.79 / $75.86	Professional		$66.07	$70.79	$75.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $15.14 / $16.60	Professional	26	$14.13	$15.14	$16.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $56.23 / $60.26	Professional	TC	$52.48	$56.23	$60.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Facility	26	$44.67	$44.67	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $74.13 / $120.23	Professional		$30.90	$74.13	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $16.98 / $23.99	Professional	26	$7.59	$16.98	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $58.88 / $95.50	Professional	TC	$23.99	$58.88	$95.50
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 Professional Modifier Low / Median / High Price $33.11 / $57.54 / $263.03	Professional		$33.11	$57.54	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $14.79 / $83.18	Professional	26	$10.23	$14.79	$83.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $42.66 / $208.93	Professional	TC	$22.91	$42.66	$208.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $85.11 / $134.90	Professional		$75.86	$85.11	$134.90
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $18.20 / $28.18	Professional	26	$15.49	$18.20	$28.18
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $67.61 / $107.15	Professional	TC	$58.88	$67.61	$107.15
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Facility	26	$44.67	$44.67	$44.67
Midlands Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $89.13 / $134.90	Professional		$47.86	$89.13	$134.90
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $16.98 / $28.18	Professional	26	$14.13	$16.98	$28.18
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $50.12 / $107.15	Professional	TC	$33.11	$50.12	$107.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $34.67 / $74.13	Professional		$8.71	$34.67	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $52.48 / $89.13	Professional		$33.11	$52.48	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $13.49 / $21.38	Professional	26	$9.12	$13.49	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $39.81 / $67.61	Professional	TC	$22.91	$39.81	$67.61