Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.56 / $170.95 / $463.98	Facility		$37.56	$170.95	$463.98
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.07 / $22.90 / $63.64	Facility	26	$7.07	$22.90	$63.64
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.12 / $123.90 / $311.64	Facility	TC	$23.12	$123.90	$311.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.69 / $50.05 / $130.94	Professional		$17.69	$50.05	$130.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.06 / $17.00 / $36.11	Professional	26	$7.06	$17.00	$36.11
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $14.12 / $65.00 / $115.25	Professional	50	$14.12	$65.00	$115.25
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.17 / $26.53 / $159.60	Professional	52	$13.17	$26.53	$159.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.92 / $26.66 / $75.38	Professional	TC	$17.92	$26.66	$75.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.48 / $48.48 / $48.48	Professional		$48.48	$48.48	$48.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.57 / $12.51 / $19.77	Professional	26	$7.57	$12.51	$19.77
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $36.97 / $36.97 / $36.97	Professional	TC	$36.97	$36.97	$36.97
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 $49.18 / $52.57 / $53.89	Professional		$49.18	$52.57	$53.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.01 / $13.90 / $14.60	Professional	26	$13.01	$13.90	$14.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.15 / $38.53 / $39.63	Professional	TC	$36.15	$38.53	$39.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $155.16 / $155.16 / $326.00	Facility		$155.16	$155.16	$326.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.04 / $41.04 / $41.04	Facility	26	$41.04	$41.04	$41.04
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $114.12 / $114.12 / $114.12	Facility	TC	$114.12	$114.12	$114.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.14 / $59.61 / $82.42	Professional		$28.14	$59.61	$82.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.65 / $16.21 / $20.36	Professional	26	$8.65	$16.21	$20.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.07 / $43.39 / $62.06	Professional	TC	$21.07	$43.39	$62.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.33 / $54.04 / $342.77	Facility		$26.33	$54.04	$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 $100.00 / $100.00 / $404.16	Facility	TC	$100.00	$100.00	$404.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.79 / $50.03 / $180.63	Professional		$30.79	$50.03	$180.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.01 / $14.58 / $67.70	Professional	26	$9.01	$14.58	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.78 / $35.39 / $154.00	Professional	TC	$21.78	$35.39	$154.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $59.61 / $93.64	Facility		$50.00	$59.61	$93.64
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $23.18 / $23.85 / $41.04	Facility	26	$23.18	$23.85	$41.04
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $36.97 / $65.72 / $114.12	Facility	TC	$36.97	$65.72	$114.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $45.69 / $56.29 / $71.09	Professional		$45.69	$56.29	$71.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.86 / $25.26 / $48.41	Professional		$7.86	$25.26	$48.41
United Facility/Professional Professional Modifier Low / Median / High Price $30.79 / $49.45 / $62.94	Professional		$30.79	$49.45	$62.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.01 / $14.64 / $18.42	Professional	26	$9.01	$14.64	$18.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.78 / $35.39 / $44.52	Professional	TC	$21.78	$35.39	$44.52