Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $190.55 / $263.03 / $812.83	Facility	26	$190.55	$263.03	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $478.63 / $2,187.76	Professional		$323.59	$478.63	$2,187.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $125.89 / $213.80	Professional	26	$81.28	$125.89	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $338.84 / $645.65	Professional	TC	$245.47	$338.84	$645.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $630.96 / $676.08	Professional		$602.56	$630.96	$676.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $158.49 / $169.82	Professional	26	$147.91	$158.49	$169.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $467.74 / $512.86	Professional	TC	$446.68	$467.74	$512.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $467.74 / $467.74 / $467.74	Facility	26	$467.74	$467.74	$467.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $794.33 / $1,023.29	Professional		$331.13	$794.33	$1,023.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $173.78 / $245.47	Professional	26	$77.62	$173.78	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $602.56 / $776.25	Professional	TC	$251.19	$602.56	$776.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $794.33 / $794.33 / $794.33	Facility	26	$794.33	$794.33	$794.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $707.95 / $3,019.95	Professional		$436.52	$707.95	$3,019.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $165.96 / $851.14	Professional	26	$104.71	$165.96	$851.14
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $537.03 / $2,570.40	Professional	TC	$323.59	$537.03	$2,570.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $758.58 / $1,148.15	Professional		$645.65	$758.58	$1,148.15
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $186.21 / $288.40	Professional	26	$162.18	$186.21	$288.40
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $562.34 / $870.96	Professional	TC	$489.78	$562.34	$870.96
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $467.74 / $467.74 / $467.74	Facility	26	$467.74	$467.74	$467.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $933.25 / $1,148.15	Professional		$758.58	$933.25	$1,148.15
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $177.83 / $288.40	Professional	26	$147.91	$177.83	$288.40
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $562.34 / $758.58 / $870.96	Professional	TC	$562.34	$758.58	$870.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $263.03 / $562.34	Professional		$87.10	$263.03	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $660.69 / $933.25	Professional		$398.11	$660.69	$933.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $158.49 / $218.78	Professional	26	$89.13	$158.49	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $524.81 / $707.95	Professional	TC	$302.00	$524.81	$707.95