Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.24 / $12.33 / $54.88	Facility	26	$12.24	$12.33	$54.88
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.94 / $29.93 / $637.98	Facility	TC	$27.94	$29.93	$637.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.09 / $40.27 / $232.00	Professional		$38.09	$40.27	$232.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.33 / $25.75 / $32.24	Professional	26	$12.33	$25.75	$32.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.42 / $27.96 / $66.39	Professional	TC	$25.42	$27.96	$66.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.21 / $13.25 / $21.83	Professional	26	$13.21	$13.25	$21.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.20 / $21.20 / $21.20	Professional	TC	$21.20	$21.20	$21.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.29 / $79.42 / $81.40	Professional		$74.29	$79.42	$81.40
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.71 / $24.28 / $25.46	Professional	26	$22.71	$24.28	$25.46
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.59 / $55.14 / $56.52	Professional	TC	$51.59	$55.14	$56.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.64 / $71.64 / $71.64	Facility	26	$71.64	$71.64	$71.64
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $162.72 / $162.72 / $162.72	Facility	TC	$162.72	$162.72	$162.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.36 / $91.08 / $124.11	Professional		$42.36	$91.08	$124.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.67 / $28.34 / $35.88	Professional	26	$14.67	$28.34	$35.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.85 / $63.93 / $88.24	Professional	TC	$28.85	$63.93	$88.24
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 $136.22 / $136.22 / $618.45	Facility	TC	$136.22	$136.22	$618.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.57 / $75.68 / $277.95	Professional		$46.57	$75.68	$277.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.74 / $25.58 / $81.06	Professional	26	$15.74	$25.58	$81.06
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.86 / $50.10 / $196.89	Professional	TC	$29.86	$50.10	$196.89
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $56.18 / $57.81 / $71.64	Facility	26	$56.18	$57.81	$71.64
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $53.00 / $105.26 / $162.72	Facility	TC	$53.00	$105.26	$162.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $71.70 / $91.08 / $113.85	Professional		$71.70	$91.08	$113.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.76 / $38.27 / $70.70	Professional		$12.76	$38.27	$70.70
United Facility/Professional Professional Modifier Low / Median / High Price $46.57 / $73.50 / $95.20	Professional		$46.57	$73.50	$95.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.74 / $25.58 / $32.18	Professional	26	$15.74	$25.58	$32.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.83 / $50.10 / $63.02	Professional	TC	$30.83	$50.10	$63.02