Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.09 / $132.00 / $326.18	Facility		$50.09	$132.00	$326.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.68 / $24.53 / $69.15	Facility	26	$7.68	$24.53	$69.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.29 / $84.31 / $193.40	Facility	TC	$24.29	$84.31	$193.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.27 / $30.51 / $132.47	Professional		$17.27	$30.51	$132.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.48 / $17.87 / $39.02	Professional	26	$7.48	$17.87	$39.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $220.00 / $220.00 / $220.00	Professional	50	$220.00	$220.00	$220.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.51 / $15.18 / $91.32	Professional	52	$14.51	$15.18	$91.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $22.68 / $45.59	Professional	TC	$18.53	$22.68	$45.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $13.54 / $17.18	Professional	26	$7.45	$13.54	$17.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $42.90 / $42.90 / $42.90	Professional	TC	$42.90	$42.90	$42.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.78 / $198.92 / $373.43	Facility		$146.78	$198.92	$373.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.46 / $59.28 / $60.75	Professional		$55.46	$59.28	$60.75
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $14.52 / $15.90	Professional	26	$13.58	$14.52	$15.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.88 / $44.75 / $45.88	Professional	TC	$41.88	$44.75	$45.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.96 / $174.96 / $326.00	Facility		$174.96	$174.96	$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 $132.12 / $132.12 / $132.12	Facility	TC	$132.12	$132.12	$132.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.01 / $68.20 / $93.08	Professional		$32.01	$68.20	$93.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.16 / $16.91 / $21.33	Professional	26	$9.16	$16.91	$21.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.57 / $51.20 / $71.75	Professional	TC	$24.57	$51.20	$71.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.36 / $57.01 / $342.77	Facility		$30.36	$57.01	$342.77
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 $110.49 / $110.49 / $445.74	Facility	TC	$110.49	$110.49	$445.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.11 / $57.08 / $206.66	Professional		$35.11	$57.08	$206.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $15.47 / $67.70	Professional	26	$9.80	$15.47	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.32 / $41.15 / $157.81	Professional	TC	$25.32	$41.15	$157.81
Midlands Facility/Professional Facility Modifier Low / Median / High Price $54.31 / $68.20 / $95.27	Facility		$54.31	$68.20	$95.27
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $25.74 / $26.49 / $42.84	Facility	26	$25.74	$26.49	$42.84
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $42.90 / $68.78 / $132.12	Facility	TC	$42.90	$68.78	$132.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $62.77 / $81.67	Professional		$46.00	$62.77	$81.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.17 / $28.51 / $54.41	Professional		$8.17	$28.51	$54.41
United Facility/Professional Facility Modifier Low / Median / High Price $81.70 / $163.63 / $206.53	Facility		$81.70	$163.63	$206.53
United Facility/Professional Professional Modifier Low / Median / High Price $35.11 / $56.40 / $71.80	Professional		$35.11	$56.40	$71.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.52 / $20.04	Professional	26	$9.33	$15.52	$20.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.32 / $41.15 / $52.75	Professional	TC	$25.32	$41.15	$52.75