Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.85 / $283.99 / $478.69	Facility	26	$52.85	$283.99	$478.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.33 / $161.94 / $518.72	Professional		$119.33	$161.94	$518.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.85 / $123.98 / $288.00	Professional	26	$52.85	$123.98	$288.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.09 / $112.11 / $879.76	Professional	TC	$109.09	$112.11	$879.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.38 / $72.68 / $122.98	Professional	26	$40.38	$72.68	$122.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.93 / $316.31 / $335.22	Professional		$295.93	$316.31	$335.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $96.81 / $103.48 / $109.40	Professional	26	$96.81	$103.48	$109.40
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $199.13 / $212.86 / $225.81	Professional	TC	$199.13	$212.86	$225.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $305.33 / $305.33 / $305.33	Facility	26	$305.33	$305.33	$305.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $252.94 / $377.55 / $529.00	Professional		$252.94	$377.55	$529.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.13 / $121.17 / $156.11	Professional	26	$70.13	$121.17	$156.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $182.81 / $254.10 / $389.45	Professional	TC	$182.81	$254.10	$389.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $514.88 / $514.88 / $514.88	Facility	26	$514.88	$514.88	$514.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $235.60 / $393.38 / $1,638.03	Professional		$235.60	$393.38	$1,638.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.12 / $112.04 / $376.34	Professional	26	$67.12	$112.04	$376.34
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $162.19 / $274.47 / $1,335.34	Professional	TC	$162.19	$274.47	$1,335.34
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $178.10 / $183.28 / $305.33	Facility	26	$178.10	$183.28	$305.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $320.49 / $439.61 / $574.00	Professional		$320.49	$439.61	$574.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $155.59 / $277.73	Professional		$54.95	$155.59	$277.73
United Facility/Professional Professional Modifier Low / Median / High Price $272.02 / $398.71 / $453.08	Professional		$272.02	$398.71	$453.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.12 / $108.82 / $137.28	Professional	26	$67.12	$108.82	$137.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $149.71 / $243.28 / $311.89	Professional	TC	$149.71	$243.28	$311.89