Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.55 / $213.24 / $577.75	Facility	26	$63.55	$213.24	$577.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.02 / $431.27 / $1,387.00	Professional		$228.02	$431.27	$1,387.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.20 / $148.26 / $205.02	Professional	26	$62.20	$148.26	$205.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $164.47 / $381.20 / $1,025.66	Professional	TC	$164.47	$381.20	$1,025.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $206.02 / $544.46 / $544.46	Professional		$206.02	$544.46	$544.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.54 / $118.38 / $147.93	Professional	26	$63.54	$118.38	$147.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $325.48 / $325.48 / $325.48	Professional	TC	$325.48	$325.48	$325.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $421.31 / $450.33 / $472.00	Professional		$421.31	$450.33	$472.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $116.51 / $124.54 / $131.55	Professional	26	$116.51	$124.54	$131.55
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $304.80 / $325.80 / $340.44	Professional	TC	$304.80	$325.80	$340.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $367.50 / $367.50 / $367.50	Facility	26	$367.50	$367.50	$367.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $303.05 / $555.35 / $774.73	Professional		$303.05	$555.35	$774.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.09 / $146.11 / $187.14	Professional	26	$84.09	$146.11	$187.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $226.40 / $406.85 / $617.00	Professional	TC	$226.40	$406.85	$617.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $619.20 / $619.20 / $619.20	Facility	26	$619.20	$619.20	$619.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $337.79 / $543.08 / $2,385.40	Professional		$337.79	$543.08	$2,385.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $80.59 / $133.46 / $533.30	Professional	26	$80.59	$133.46	$533.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $249.31 / $416.28 / $2,603.00	Professional	TC	$249.31	$416.28	$2,603.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $218.15 / $224.51 / $367.50	Facility	26	$218.15	$224.51	$367.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $456.27 / $567.01 / $799.00	Professional		$456.27	$567.01	$799.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $71.88 / $209.86 / $481.85	Professional		$71.88	$209.86	$481.85
United Facility/Professional Professional Modifier Low / Median / High Price $337.79 / $537.96 / $631.66	Professional		$337.79	$537.96	$631.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.59 / $131.15 / $165.45	Professional	26	$80.59	$131.15	$165.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $249.31 / $404.50 / $479.45	Professional	TC	$249.31	$404.50	$479.45