Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $177.83 / $537.03	Facility	26	$125.89	$177.83	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $245.47 / $501.19	Professional		$138.04	$245.47	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $70.79 / $144.54	Professional	26	$50.12	$70.79	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $213.80 / $354.81	Professional	TC	$128.82	$213.80	$354.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $43.65 / $43.65	Professional	26	$43.65	$43.65	$43.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $363.08 / $389.05	Professional		$346.74	$363.08	$389.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $107.15 / $114.82	Professional	26	$100.00	$107.15	$114.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $257.04 / $371.54	Professional	TC	$186.21	$257.04	$371.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $316.23 / $316.23 / $316.23	Facility	26	$316.23	$316.23	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $467.74 / $616.60	Professional		$229.09	$467.74	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $109.65 / $165.96	Professional	26	$52.48	$109.65	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $331.13 / $501.19	Professional	TC	$162.18	$331.13	$501.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $537.03 / $537.03 / $537.03	Facility	26	$537.03	$537.03	$537.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $436.52 / $2,089.30	Professional		$263.03	$436.52	$2,089.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $109.65 / $380.19	Professional	26	$70.79	$109.65	$380.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $346.74 / $1,737.80	Professional	TC	$190.55	$346.74	$1,737.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $436.52 / $676.08	Professional		$380.19	$436.52	$676.08
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $125.89 / $190.55	Professional	26	$109.65	$125.89	$190.55
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $309.03 / $478.63	Professional	TC	$269.15	$309.03	$478.63
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $316.23 / $316.23 / $316.23	Facility	26	$316.23	$316.23	$316.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $616.60 / $676.08	Professional		$436.52	$616.60	$676.08
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $120.23 / $190.55	Professional	26	$100.00	$120.23	$190.55
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $478.63 / $537.03	Professional	TC	$309.03	$478.63	$537.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $144.54 / $331.13	Professional		$58.88	$144.54	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $398.11 / $562.34	Professional		$239.88	$398.11	$562.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $107.15 / $144.54	Professional	26	$61.66	$107.15	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $295.12 / $407.38	Professional	TC	$173.78	$295.12	$407.38