Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $269.15 / $537.03	Facility		$53.70	$269.15	$537.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $17.38 / $54.95	Facility	26	$10.00	$17.38	$54.95
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $42.66 / $269.15 / $645.65	Facility	TC	$42.66	$269.15	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $38.90 / $125.89	Professional		$8.51	$38.90	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $15.85 / $39.81	Professional	26	$7.41	$15.85	$39.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.18 / $89.13 / $169.82	Professional	50	$28.18	$89.13	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $41.69 / $85.11	Professional	TC	$22.91	$41.69	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $26.92 / $63.10	Professional		$21.38	$26.92	$63.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.91 / $15.49	Professional	26	$6.03	$8.91	$15.49
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $30.90 / $38.90 / $83.18	Professional	50	$30.90	$38.90	$83.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $28.84 / $48.98	Professional	TC	$17.78	$28.84	$48.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $251.19 / $363.08	Facility		$147.91	$251.19	$363.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $61.66 / $64.57	Professional		$56.23	$61.66	$64.57
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $15.14 / $15.85	Professional	26	$14.13	$15.14	$15.85
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $46.77 / $48.98	Professional	TC	$42.66	$46.77	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $323.59	Facility		$186.21	$186.21	$323.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Facility	26	$44.67	$44.67	$44.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $141.25 / $141.25 / $141.25	Facility	TC	$141.25	$141.25	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $64.57 / $102.33	Professional		$26.30	$64.57	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $16.98 / $22.91	Professional	26	$7.24	$16.98	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $48.98 / $77.62	Professional	TC	$19.95	$48.98	$77.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $288.40 / $407.38	Facility		$53.70	$288.40	$407.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $100.00 / $100.00	Facility	26	$53.70	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $117.49 / $338.84 / $467.74	Facility	TC	$117.49	$338.84	$467.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $53.70 / $223.87	Professional		$33.11	$53.70	$223.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $15.14 / $19.95	Professional	26	$9.77	$15.14	$19.95
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $37.15 / $169.82	Professional	TC	$23.99	$37.15	$169.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $72.44 / $114.82	Professional		$64.57	$72.44	$114.82
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $19.05 / $26.92	Professional	26	$15.49	$19.05	$26.92
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $54.95 / $89.13	Professional	TC	$48.98	$54.95	$89.13
Midlands Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Facility		$186.21	$186.21	$186.21
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Facility	26	$44.67	$44.67	$44.67
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $45.71 / $141.25 / $141.25	Facility	TC	$45.71	$141.25	$141.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $52.48 / $114.82	Professional		$50.12	$52.48	$114.82
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $16.98 / $18.20	Professional	26	$14.13	$16.98	$18.20
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $36.31 / $89.13	Professional	TC	$36.31	$36.31	$89.13
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $269.15 / $275.42	Facility		$234.42	$269.15	$275.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $26.92 / $57.54	Professional		$8.32	$26.92	$57.54
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 $31.62 / $45.71 / $74.13	Professional		$31.62	$45.71	$74.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.88 / $20.42	Professional	26	$8.71	$12.88	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.11 / $54.95	Professional	TC	$22.91	$33.11	$54.95