Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.25 / $269.48 / $506.00	Facility		$54.25	$269.48	$506.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.71 / $19.11 / $69.48	Facility	26	$7.71	$19.11	$69.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.96 / $268.70 / $645.41	Facility	TC	$39.96	$268.70	$645.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.56 / $41.36 / $127.22	Professional		$8.56	$41.36	$127.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.47 / $17.88 / $41.36	Professional	26	$7.47	$17.88	$41.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $37.59 / $93.00 / $260.00	Professional	50	$37.59	$93.00	$260.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.42 / $15.97 / $94.40	Professional	52	$15.42	$15.97	$94.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.94 / $42.19 / $108.00	Professional	TC	$22.94	$42.19	$108.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.25 / $58.20 / $79.04	Professional		$24.25	$58.20	$79.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.98 / $14.39 / $17.98	Professional	26	$5.98	$14.39	$17.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.35 / $18.35 / $47.49	Professional	TC	$18.35	$18.35	$47.49
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 $58.93 / $63.00 / $64.56	Professional		$58.93	$63.00	$64.56
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.21 / $15.18 / $15.96	Professional	26	$14.21	$15.18	$15.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.06 / $47.82 / $49.02	Professional	TC	$43.06	$47.82	$49.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $185.94 / $185.94 / $326.00	Facility		$185.94	$185.94	$326.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.82 / $44.82 / $44.82	Facility	26	$44.82	$44.82	$44.82
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $141.12 / $141.12 / $141.12	Facility	TC	$141.12	$141.12	$141.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $72.58 / $98.90	Professional		$33.11	$72.58	$98.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.40 / $17.71 / $22.30	Professional	26	$9.40	$17.71	$22.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.96 / $55.43 / $76.59	Professional	TC	$24.96	$55.43	$76.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.90 / $244.00 / $398.36	Facility		$47.90	$244.00	$398.36
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $53.20 / $100.00 / $100.00	Facility	26	$53.20	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $118.08 / $332.50 / $470.47	Facility	TC	$118.08	$332.50	$470.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.34 / $59.05 / $221.82	Professional		$36.34	$59.05	$221.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.84 / $15.60 / $23.58	Professional	26	$9.84	$15.60	$23.58
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.50 / $43.06 / $170.86	Professional	TC	$26.50	$43.06	$170.86
Midlands Facility/Professional Facility Modifier Low / Median / High Price $55.41 / $72.58 / $111.86	Facility		$55.41	$72.58	$111.86
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $25.80 / $26.55 / $44.82	Facility	26	$25.80	$26.55	$44.82
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $45.88 / $77.58 / $141.12	Facility	TC	$45.88	$77.58	$141.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $66.69 / $91.06	Professional		$50.00	$66.69	$91.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.18 / $30.31 / $57.17	Professional		$8.18	$30.31	$57.17
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 $36.34 / $60.59 / $74.28	Professional		$36.34	$60.59	$74.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.84 / $15.80 / $20.12	Professional	26	$9.84	$15.80	$20.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.26 / $44.99 / $54.16	Professional	TC	$24.26	$44.99	$54.16