Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $131.83 / $407.38	Facility	26	$77.62	$131.83	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $275.42 / $676.08	Professional		$66.07	$275.42	$676.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $134.90 / $316.23	Professional	26	$60.26	$134.90	$316.23
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $309.03 / $309.03 / $478.63	Professional	50	$309.03	$309.03	$478.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $338.84 / $912.01	Professional	TC	$134.90	$338.84	$912.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $165.96 / $407.38	Professional		$134.90	$165.96	$407.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $67.61 / $123.03	Professional	26	$48.98	$67.61	$123.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $104.71 / $263.03	Professional	TC	$104.71	$104.71	$263.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $380.19 / $407.38	Professional		$363.08	$380.19	$407.38
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $120.23 / $128.82	Professional	26	$112.20	$120.23	$128.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $257.04 / $346.74	Professional	TC	$234.42	$257.04	$346.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $354.81 / $354.81 / $354.81	Facility	26	$354.81	$354.81	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $489.78 / $776.25	Professional		$194.98	$489.78	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $131.83 / $186.21	Professional	26	$58.88	$131.83	$186.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $331.13 / $660.69	Professional	TC	$138.04	$331.13	$660.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $602.56 / $602.56 / $602.56	Facility	26	$602.56	$602.56	$602.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $426.58 / $2,818.38	Professional		$251.19	$426.58	$2,818.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $125.89 / $190.55	Professional	26	$79.43	$125.89	$190.55
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $331.13 / $2,454.71	Professional	TC	$177.83	$331.13	$2,454.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $457.09 / $707.95	Professional		$398.11	$457.09	$707.95
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $141.25 / $213.80	Professional	26	$123.03	$141.25	$213.80
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $309.03 / $489.78	Professional	TC	$269.15	$309.03	$489.78
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $354.81 / $354.81 / $354.81	Facility	26	$354.81	$354.81	$354.81
Midlands Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $707.95 / $870.96	Professional		$457.09	$707.95	$870.96
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $131.83 / $213.80	Professional	26	$125.89	$131.83	$213.80
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $489.78 / $741.31	Professional	TC	$309.03	$489.78	$741.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $144.54 / $346.74	Professional		$66.07	$144.54	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $426.58 / $676.08	Professional		$234.42	$426.58	$676.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $120.23 / $165.96	Professional	26	$69.18	$120.23	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $295.12 / $501.19	Professional	TC	$162.18	$295.12	$501.19