Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $169.82 / $426.58	Facility		$57.54	$169.82	$426.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $16.98 / $63.10	Facility	26	$10.00	$16.98	$63.10
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.81 / $79.43 / $194.98	Facility	TC	$39.81	$79.43	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $33.88 / $120.23	Professional		$14.79	$33.88	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $17.38 / $38.02	Professional	26	$7.08	$17.38	$38.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $24.55 / $158.49 / $218.78	Professional	50	$24.55	$158.49	$218.78
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.84 / $39.81 / $66.07	Professional	52	$28.84	$39.81	$66.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.70 / $54.95	Professional	TC	$19.05	$25.70	$54.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $25.12 / $63.10	Professional		$21.38	$25.12	$63.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.72 / $15.14	Professional	26	$6.03	$10.72	$15.14
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $69.18 / $69.18 / $69.18	Professional	50	$69.18	$69.18	$69.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $22.91 / $28.84	Professional	TC	$17.38	$22.91	$28.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $181.97 / $371.54	Facility		$144.54	$181.97	$371.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $57.54 / $60.26	Professional		$54.95	$57.54	$60.26
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $14.45 / $15.85	Professional	26	$13.49	$14.45	$15.85
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $43.65 / $45.71	Professional	TC	$39.81	$43.65	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $323.59	Facility		$173.78	$173.78	$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 $131.83 / $131.83 / $131.83	Facility	TC	$131.83	$131.83	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $60.26 / $95.50	Professional		$25.12	$60.26	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $15.85 / $21.88	Professional	26	$7.24	$15.85	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $45.71 / $74.13	Professional	TC	$18.62	$45.71	$74.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $60.26 / $354.81	Facility		$28.18	$60.26	$354.81
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 / $109.65 / $446.68	Facility	TC	$109.65	$109.65	$446.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $46.77 / $208.93	Professional		$29.51	$46.77	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $14.13 / $67.61	Professional	26	$9.33	$14.13	$67.61
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $33.88 / $158.49	Professional	TC	$21.38	$33.88	$158.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $67.61 / $109.65	Professional		$60.26	$67.61	$109.65
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 $45.71 / $51.29 / $83.18	Professional	TC	$45.71	$51.29	$83.18
Midlands Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
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 / $131.83 / $131.83	Facility	TC	$42.66	$131.83	$131.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $48.98 / $109.65	Professional		$45.71	$48.98	$109.65
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $15.85 / $26.30	Professional	26	$12.88	$15.85	$26.30
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $33.11 / $83.18	Professional	TC	$33.11	$33.11	$83.18
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $295.12	Facility		$257.04	$257.04	$295.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $25.12 / $54.95	Professional		$8.32	$25.12	$54.95
United Facility/Professional Facility Modifier Low / Median / High Price $8.71 / $81.28 / $204.17	Facility		$8.71	$81.28	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $43.65 / $70.79	Professional		$29.51	$43.65	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $12.59 / $20.42	Professional	26	$8.51	$12.59	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $31.62 / $52.48	Professional	TC	$21.38	$31.62	$52.48