Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.18 / $181.08 / $490.64	Facility	26	$54.18	$181.08	$490.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.16 / $263.42 / $791.00	Professional		$133.16	$263.42	$791.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.18 / $126.57 / $234.00	Professional	26	$54.18	$126.57	$234.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.98 / $172.62 / $509.77	Professional	TC	$78.98	$172.62	$509.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $330.09 / $330.09 / $330.09	Professional		$330.09	$330.09	$330.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $74.50 / $103.48 / $126.07	Professional	26	$74.50	$103.48	$126.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.69 / $58.69 / $58.69	Professional	TC	$58.69	$58.69	$58.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $243.34 / $260.12 / $275.63	Professional		$243.34	$260.12	$275.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $99.25 / $106.08 / $112.15	Professional	26	$99.25	$106.08	$112.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.11 / $154.03 / $162.19	Professional	TC	$144.11	$154.03	$162.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $313.02 / $313.02 / $313.02	Facility	26	$313.02	$313.02	$313.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.87 / $309.98 / $469.84	Professional		$169.87	$309.98	$469.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.50 / $124.58 / $159.99	Professional	26	$67.50	$124.58	$159.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.05 / $183.40 / $280.77	Professional	TC	$98.05	$183.40	$280.77
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $527.60 / $527.60 / $527.60	Facility	26	$527.60	$527.60	$527.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $182.12 / $295.33 / $1,561.56	Professional		$182.12	$295.33	$1,561.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $68.40 / $114.86 / $386.35	Professional	26	$68.40	$114.86	$386.35
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $106.74 / $180.64 / $1,649.00	Professional	TC	$106.74	$180.64	$1,649.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $183.05 / $188.38 / $313.02	Facility	26	$183.05	$188.38	$313.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $263.56 / $327.52 / $476.00	Professional		$263.56	$327.52	$476.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.16 / $106.63 / $255.20	Professional		$61.16	$106.63	$255.20
United Facility/Professional Professional Modifier Low / Median / High Price $168.11 / $285.47 / $415.88	Professional		$168.11	$285.47	$415.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.40 / $113.06 / $140.94	Professional	26	$68.40	$113.06	$140.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.53 / $167.44 / $230.96	Professional	TC	$98.53	$167.44	$230.96