Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.50 / $240.76 / $379.76	Facility		$48.50	$240.76	$379.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.39 / $19.89 / $72.20	Facility	26	$7.39	$19.89	$72.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.47 / $121.37 / $336.14	Facility	TC	$26.47	$121.37	$336.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.52 / $34.85 / $116.26	Professional		$8.52	$34.85	$116.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.26 / $17.30 / $39.26	Professional	26	$7.26	$17.30	$39.26
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $210.00 / $210.00 / $210.00	Professional	50	$210.00	$210.00	$210.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.94 / $37.20 / $104.18	Professional	TC	$19.94	$37.20	$104.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.57 / $54.16 / $54.16	Professional		$22.57	$54.16	$54.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $13.04 / $17.18	Professional	26	$7.90	$13.04	$17.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.30 / $20.30 / $42.32	Professional	TC	$20.30	$20.30	$42.32
BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.78 / $215.90 / $373.43	Facility		$146.78	$215.90	$373.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.32 / $58.06 / $59.50	Professional		$54.32	$58.06	$59.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $14.52 / $15.26	Professional	26	$13.58	$14.52	$15.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $43.53 / $44.63	Professional	TC	$40.74	$43.53	$44.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $171.36 / $171.36 / $326.00	Facility		$171.36	$171.36	$326.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.84 / $42.84 / $42.84	Facility	26	$42.84	$42.84	$42.84
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $128.52 / $128.52 / $128.52	Facility	TC	$128.52	$128.52	$128.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.96 / $66.68 / $92.11	Professional		$30.96	$66.68	$92.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $16.91 / $21.33	Professional	26	$9.02	$16.91	$21.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.40 / $49.77 / $70.78	Professional	TC	$23.40	$49.77	$70.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.19 / $78.09 / $456.12	Facility		$42.19	$78.09	$456.12
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 $109.00 / $109.00 / $397.44	Facility	TC	$109.00	$109.00	$397.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.94 / $55.15 / $202.34	Professional		$33.94	$55.15	$202.34
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $15.29 / $75.00	Professional	26	$9.41	$15.29	$75.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.36 / $39.86 / $163.00	Professional	TC	$24.36	$39.86	$163.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $54.67 / $66.68 / $103.15	Facility		$54.67	$66.68	$103.15
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $27.53 / $42.84	Facility	26	$26.75	$27.53	$42.84
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $42.32 / $63.97 / $128.52	Facility	TC	$42.32	$63.97	$128.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $61.48 / $83.78	Professional		$48.00	$61.48	$83.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.85 / $25.40 / $52.76	Professional		$7.85	$25.40	$52.76
United Facility/Professional Professional Modifier Low / Median / High Price $33.94 / $54.88 / $69.37	Professional		$33.94	$54.88	$69.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $15.11 / $19.23	Professional	26	$9.41	$15.11	$19.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.53 / $39.86 / $50.14	Professional	TC	$24.53	$39.86	$50.14