Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $251.19 / $524.81	Facility		$51.29	$251.19	$524.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.12 / $16.60 / $66.07	Facility	26	$9.12	$16.60	$66.07
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $38.90 / $102.33 / $363.08	Facility	TC	$38.90	$102.33	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $33.11 / $114.82	Professional		$8.13	$33.11	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.13 / $38.90	Professional	26	$7.08	$14.13	$38.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $77.62 / $158.49 / $208.93	Professional	50	$77.62	$158.49	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $36.31 / $75.86	Professional	TC	$19.95	$36.31	$75.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $23.99 / $60.26	Professional		$19.50	$23.99	$60.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $8.51 / $15.14	Professional	26	$5.89	$8.51	$15.14
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $66.07 / $66.07 / $102.33	Professional	50	$66.07	$66.07	$102.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $22.91 / $40.74	Professional	TC	$14.79	$22.91	$40.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $190.55 / $363.08	Facility		$144.54	$190.55	$363.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $56.23 / $58.88	Professional		$52.48	$56.23	$58.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $14.45 / $15.14	Professional	26	$13.49	$14.45	$15.14
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $42.66 / $44.67	Professional	TC	$38.90	$42.66	$44.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $323.59	Facility		$169.82	$169.82	$323.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $42.66 / $42.66	Facility	26	$42.66	$42.66	$42.66
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	TC	$128.82	$128.82	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $58.88 / $93.33	Professional		$24.55	$58.88	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $16.22 / $21.88	Professional	26	$7.08	$16.22	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $43.65 / $72.44	Professional	TC	$18.20	$43.65	$72.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $173.78 / $467.74	Facility		$42.66	$173.78	$467.74
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 $109.65 / $223.87 / $398.11	Facility	TC	$109.65	$223.87	$398.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $47.86 / $204.17	Professional		$30.90	$47.86	$204.17
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $14.13 / $23.99	Professional	26	$9.33	$14.13	$23.99
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $32.36 / $162.18	Professional	TC	$21.38	$32.36	$162.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $66.07 / $107.15	Professional		$58.88	$66.07	$107.15
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $16.98 / $26.30	Professional	26	$14.79	$16.98	$26.30
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $50.12 / $81.28	Professional	TC	$43.65	$50.12	$81.28
Midlands Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $42.66 / $42.66	Facility	26	$42.66	$42.66	$42.66
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $42.66 / $128.82 / $128.82	Facility	TC	$42.66	$128.82	$128.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $52.48 / $107.15	Professional		$47.86	$52.48	$107.15
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $16.98 / $26.30	Professional	26	$14.13	$16.98	$26.30
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $44.67 / $81.28	Professional	TC	$33.88	$44.67	$81.28
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $2,290.87	Facility		$1,949.84	$1,949.84	$2,290.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $24.55 / $53.70	Professional		$7.94	$24.55	$53.70
United Facility/Professional Facility Modifier Low / Median / High Price $9.33 / $81.28 / $204.17	Facility		$9.33	$81.28	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $42.66 / $69.18	Professional		$29.51	$42.66	$69.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $12.59 / $19.50	Professional	26	$8.51	$12.59	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.90 / $50.12	Professional	TC	$19.95	$30.90	$50.12