Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.21 / $267.83 / $551.50	Facility		$60.21	$267.83	$551.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.03 / $20.14 / $73.30	Facility	26	$8.03	$20.14	$73.30
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.49 / $292.70 / $546.28	Facility	TC	$35.49	$292.70	$546.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.23 / $38.00 / $135.00	Professional		$8.23	$38.00	$135.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $18.05 / $42.00	Professional	26	$7.78	$18.05	$42.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.95 / $95.00 / $137.36	Professional	50	$40.95	$95.00	$137.36
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.48 / $17.21 / $100.66	Professional	52	$16.48	$17.21	$100.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.52 / $45.92 / $121.00	Professional	TC	$24.52	$45.92	$121.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.53 / $62.19 / $78.92	Professional		$27.53	$62.19	$78.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.37 / $11.51 / $18.69	Professional	26	$6.37	$11.51	$18.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.77 / $49.44 / $51.17	Professional	TC	$19.77	$49.44	$51.17
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 $62.93 / $67.28 / $68.95	Professional		$62.93	$67.28	$68.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.77 / $15.80 / $16.60	Professional	26	$14.77	$15.80	$16.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.18 / $51.47 / $52.77	Professional	TC	$47.18	$51.47	$52.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $198.54 / $198.54 / $326.00	Facility		$198.54	$198.54	$326.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.62 / $46.62 / $46.62	Facility	26	$46.62	$46.62	$46.62
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $151.91 / $151.91 / $151.91	Facility	TC	$151.91	$151.91	$151.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $77.56 / $105.69	Professional		$35.22	$77.56	$105.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $18.39 / $23.27	Professional	26	$9.77	$18.39	$23.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.90 / $59.69 / $82.42	Professional	TC	$26.90	$59.69	$82.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $50.45 / $229.32 / $387.53	Facility		$50.45	$229.32	$387.53
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 $127.16 / $296.42 / $391.40	Facility	TC	$127.16	$296.42	$391.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.70 / $62.88 / $237.03	Professional		$38.70	$62.88	$237.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.24 / $16.26 / $24.51	Professional	26	$10.24	$16.26	$24.51
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.46 / $46.25 / $183.85	Professional	TC	$28.46	$46.25	$183.85
Midlands Facility/Professional Facility Modifier Low / Median / High Price $60.11 / $77.56 / $109.90	Facility		$60.11	$77.56	$109.90
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $26.90 / $27.69 / $46.62	Facility	26	$26.90	$27.69	$46.62
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $49.44 / $82.22 / $151.91	Facility	TC	$49.44	$82.22	$151.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $51.00 / $71.19 / $96.59	Professional		$51.00	$71.19	$96.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $32.36 / $62.08	Professional		$8.51	$32.36	$62.08
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 $38.70 / $62.15 / $79.11	Professional		$38.70	$62.15	$79.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.24 / $16.44 / $21.33	Professional	26	$10.24	$16.44	$21.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.46 / $41.31 / $58.19	Professional	TC	$28.46	$41.31	$58.19