Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $323.59 / $954.99	Facility	26	$213.80	$323.59	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $512.86 / $1,023.29	Professional		$338.84	$512.86	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $141.25 / $380.19	Professional	26	$89.13	$141.25	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $416.87 / $707.95	Professional	TC	$251.19	$416.87	$707.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $117.49 / $199.53	Professional	26	$79.43	$117.49	$199.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $707.95 / $741.31	Professional		$676.08	$707.95	$741.31
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $190.55 / $204.17	Professional	26	$181.97	$190.55	$204.17
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $512.86 / $562.34	Professional	TC	$389.05	$512.86	$562.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $575.44 / $575.44 / $575.44	Facility	26	$575.44	$575.44	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $831.76 / $1,148.15	Professional		$302.00	$831.76	$1,148.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $199.53 / $302.00	Professional	26	$83.18	$199.53	$302.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $630.96 / $851.14	Professional	TC	$229.09	$630.96	$851.14
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $977.24 / $977.24 / $977.24	Facility	26	$977.24	$977.24	$977.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $741.31 / $2,570.40	Professional		$457.09	$741.31	$2,570.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $199.53 / $263.03	Professional	26	$128.82	$199.53	$263.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $549.54 / $2,041.74	Professional	TC	$323.59	$549.54	$2,041.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $851.14 / $1,318.26	Professional		$741.31	$851.14	$1,318.26
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $229.09 / $354.81	Professional	26	$199.53	$229.09	$354.81
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $630.96 / $954.99	Professional	TC	$537.03	$630.96	$954.99
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $575.44 / $575.44 / $575.44	Facility	26	$575.44	$575.44	$575.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $851.14 / $1,318.26	Professional		$741.31	$851.14	$1,318.26
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $234.42 / $354.81	Professional	26	$199.53	$234.42	$354.81
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $630.96 / $954.99	Professional	TC	$537.03	$630.96	$954.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $288.40 / $645.65	Professional		$104.71	$288.40	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $707.95 / $977.24	Professional		$416.87	$707.95	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $190.55 / $263.03	Professional	26	$112.20	$190.55	$263.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $524.81 / $707.95	Professional	TC	$302.00	$524.81	$707.95