Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $269.15 / $549.54	Facility		$57.54	$269.15	$549.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $16.98 / $54.95	Facility	26	$10.00	$16.98	$54.95
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $45.71 / $275.42 / $549.54	Facility	TC	$45.71	$275.42	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $38.90 / $128.82	Professional		$8.32	$38.90	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $16.22 / $41.69	Professional	26	$7.76	$16.22	$41.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.74 / $95.50 / $213.80	Professional	50	$40.74	$95.50	$213.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $60.26 / $60.26 / $60.26	Professional	52	$60.26	$60.26	$60.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $44.67 / $114.82	Professional	TC	$23.99	$44.67	$114.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $27.54 / $66.07	Professional		$22.39	$27.54	$66.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $9.33 / $16.22	Professional	26	$6.31	$9.33	$16.22
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $42.66 / $117.49	Professional	50	$36.31	$42.66	$117.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $29.51 / $51.29	Professional	TC	$17.78	$29.51	$51.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $218.78 / $323.59	Facility		$147.91	$218.78	$323.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $66.07 / $69.18	Professional		$60.26	$66.07	$69.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $15.49 / $16.60	Professional	26	$14.79	$15.49	$16.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $50.12 / $52.48	Professional	TC	$45.71	$50.12	$52.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $323.59	Facility		$199.53	$199.53	$323.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $46.77 / $46.77	Facility	26	$46.77	$46.77	$46.77
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $151.36 / $151.36 / $151.36	Facility	TC	$151.36	$151.36	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $67.61 / $107.15	Professional		$28.18	$67.61	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $16.98 / $23.99	Professional	26	$7.59	$16.98	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $52.48 / $85.11	Professional	TC	$21.38	$52.48	$85.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $275.42 / $398.11	Facility		$57.54	$275.42	$398.11
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 $125.89 / $295.12 / $389.05	Facility	TC	$125.89	$295.12	$389.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $56.23 / $234.42	Professional		$33.88	$56.23	$234.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $15.85 / $21.38	Professional	26	$10.23	$15.85	$21.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $39.81 / $181.97	Professional	TC	$23.99	$39.81	$181.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $77.62 / $123.03	Professional		$69.18	$77.62	$123.03
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $18.20 / $28.18	Professional	26	$16.22	$18.20	$28.18
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $60.26 / $95.50	Professional	TC	$52.48	$60.26	$95.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $46.77 / $46.77	Facility	26	$46.77	$46.77	$46.77
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $48.98 / $151.36 / $151.36	Facility	TC	$48.98	$151.36	$151.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $52.48 / $123.03	Professional		$51.29	$52.48	$123.03
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $16.98 / $28.18	Professional	26	$14.13	$16.98	$28.18
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $37.15 / $95.50	Professional	TC	$36.31	$37.15	$95.50
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 $8.71 / $29.51 / $63.10	Professional		$8.71	$29.51	$63.10
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 $33.88 / $47.86 / $79.43	Professional		$33.88	$47.86	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.49 / $21.38	Professional	26	$8.91	$13.49	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $35.48 / $58.88	Professional	TC	$23.44	$35.48	$58.88