Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.66 / $14.35 / $20.27	Facility	26	$10.66	$14.35	$20.27
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.69 / $274.52 / $455.04	Facility	TC	$28.69	$274.52	$455.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.49 / $49.88 / $180.00	Professional		$34.49	$49.88	$180.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.67 / $22.09 / $47.20	Professional	26	$10.67	$22.09	$47.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.82 / $39.61 / $89.60	Professional	TC	$21.82	$39.61	$89.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.09 / $37.11 / $80.77	Professional		$29.09	$37.11	$80.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.62 / $14.70 / $21.37	Professional	26	$10.62	$14.70	$21.37
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.35 / $45.88 / $47.49	Professional	TC	$18.35	$45.88	$47.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.24 / $67.59 / $69.29	Professional		$63.24	$67.59	$69.29
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.09 / $20.39 / $21.85	Professional	26	$19.09	$20.39	$21.85
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.17 / $47.21 / $48.39	Professional	TC	$44.17	$47.21	$48.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.18 / $60.18 / $60.18	Facility	26	$60.18	$60.18	$60.18
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $139.32 / $139.32 / $139.32	Facility	TC	$139.32	$139.32	$139.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.26 / $78.52 / $107.63	Professional		$39.26	$78.52	$107.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.79 / $24.50 / $31.03	Professional	26	$12.79	$24.50	$31.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.35 / $54.01 / $76.59	Professional	TC	$25.35	$54.01	$76.59
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.00 / $70.00 / $70.00	Facility	26	$70.00	$70.00	$70.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $118.08 / $118.08 / $416.10	Facility	TC	$118.08	$118.08	$416.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.11 / $65.19 / $236.84	Professional		$40.11	$65.19	$236.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.62 / $21.44 / $32.60	Professional	26	$13.62	$21.44	$32.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.63 / $43.06 / $166.53	Professional	TC	$25.63	$43.06	$166.53
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $47.58 / $48.96 / $60.18	Facility	26	$47.58	$48.96	$60.18
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $45.88 / $90.41 / $139.32	Facility	TC	$45.88	$90.41	$139.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.80 / $78.52 / $98.34	Professional		$61.80	$78.52	$98.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.08 / $33.13 / $60.92	Professional		$11.08	$33.13	$60.92
United Facility/Professional Professional Modifier Low / Median / High Price $40.11 / $65.19 / $82.00	Professional		$40.11	$65.19	$82.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.62 / $21.61 / $27.84	Professional	26	$13.62	$21.61	$27.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.50 / $42.55 / $54.16	Professional	TC	$26.50	$42.55	$54.16