Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $165.96 / $707.95	Facility	26	$95.50	$165.96	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $478.63 / $1,000.00	Professional		$177.83	$478.63	$1,000.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $165.96 / $371.54	Professional	26	$74.13	$165.96	$371.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $354.81 / $616.60	Professional	TC	$234.42	$354.81	$616.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $724.44	Professional		$691.83	$691.83	$724.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $87.10 / $147.91	Professional	26	$57.54	$87.10	$147.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $588.84 / $630.96	Professional		$562.34	$588.84	$630.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $144.54 / $154.88	Professional	26	$134.90	$144.54	$154.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $446.68 / $616.60	Professional	TC	$416.87	$446.68	$616.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $426.58 / $426.58 / $426.58	Facility	26	$426.58	$426.58	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $741.31 / $1,023.29	Professional		$309.03	$741.31	$1,023.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $154.88 / $223.87	Professional	26	$70.79	$154.88	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $562.34 / $812.83	Professional	TC	$239.88	$562.34	$812.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $724.44 / $724.44 / $724.44	Facility	26	$724.44	$724.44	$724.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $676.08 / $3,311.31	Professional		$407.38	$676.08	$3,311.31
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $151.36 / $602.56	Professional	26	$93.33	$151.36	$602.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $524.81 / $2,951.21	Professional	TC	$316.23	$524.81	$2,951.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $707.95 / $1,071.52	Professional		$616.60	$707.95	$1,071.52
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $169.82 / $257.04	Professional	26	$147.91	$169.82	$257.04
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $537.03 / $812.83	Professional	TC	$457.09	$537.03	$812.83
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $426.58 / $426.58 / $426.58	Facility	26	$426.58	$426.58	$426.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,023.29 / $1,071.52	Professional		$707.95	$1,023.29	$1,071.52
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $158.49 / $257.04	Professional	26	$154.88	$158.49	$257.04
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $812.83 / $891.25	Professional	TC	$537.03	$812.83	$891.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $245.47 / $524.81	Professional		$77.62	$245.47	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $645.65 / $891.25	Professional		$371.54	$645.65	$891.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $141.25 / $199.53	Professional	26	$83.18	$141.25	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $489.78 / $676.08	Professional	TC	$288.40	$489.78	$676.08