Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.39 / $146.65 / $412.34	Facility	26	$45.39	$146.65	$412.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.48 / $116.36 / $363.32	Professional		$44.48	$116.36	$363.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.48 / $59.09 / $220.95	Professional	26	$44.48	$59.09	$220.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $80.53 / $201.03 / $303.82	Professional	TC	$80.53	$201.03	$303.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $289.61 / $289.61 / $311.37	Professional		$289.61	$289.61	$311.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.38 / $65.13 / $105.80	Professional	26	$45.38	$65.13	$105.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $60.35 / $60.35 / $150.88	Professional	TC	$60.35	$60.35	$150.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $230.19 / $246.06 / $260.64	Professional		$230.19	$246.06	$260.64
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.23 / $88.95 / $93.56	Professional	26	$83.23	$88.95	$93.56
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $146.97 / $157.09 / $166.69	Professional	TC	$146.97	$157.09	$166.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $262.50 / $262.50 / $262.50	Facility	26	$262.50	$262.50	$262.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.62 / $294.80 / $438.00	Professional		$201.62	$294.80	$438.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.42 / $104.44 / $133.81	Professional	26	$60.42	$104.44	$133.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.21 / $188.60 / $288.68	Professional	TC	$141.21	$188.60	$288.68
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $442.24 / $442.24 / $442.24	Facility	26	$442.24	$442.24	$442.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $188.44 / $292.33 / $1,378.78	Professional		$188.44	$292.33	$1,378.78
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $62.60 / $95.02 / $300.10	Professional	26	$62.60	$95.02	$300.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $125.09 / $212.20 / $1,332.00	Professional	TC	$125.09	$212.20	$1,332.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $154.27 / $158.77 / $262.50	Facility	26	$154.27	$158.77	$262.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $249.30 / $350.56 / $447.20	Professional		$249.30	$350.56	$447.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.52 / $116.86 / $220.09	Professional		$47.52	$116.86	$220.09
United Facility/Professional Professional Modifier Low / Median / High Price $188.44 / $282.64 / $359.50	Professional		$188.44	$282.64	$359.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.48 / $95.02 / $118.46	Professional	26	$58.48	$95.02	$118.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.09 / $211.68 / $240.55	Professional	TC	$125.09	$211.68	$240.55