Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.61 / $193.88 / $684.23	Facility	26	$99.61	$193.88	$684.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $297.29 / $354.51 / $1,433.00	Professional		$297.29	$354.51	$1,433.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.70 / $115.93 / $317.79	Professional	26	$79.70	$115.93	$317.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $214.28 / $297.57 / $1,004.50	Professional	TC	$214.28	$297.57	$1,004.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $220.08 / $308.11 / $670.31	Professional		$220.08	$308.11	$670.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.06 / $154.88 / $193.54	Professional	26	$76.06	$154.88	$193.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $219.15 / $219.15 / $405.04	Professional	TC	$219.15	$219.15	$405.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $538.64 / $575.75 / $594.58	Professional		$538.64	$575.75	$594.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $151.62 / $162.06 / $171.83	Professional	26	$151.62	$162.06	$171.83
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $387.04 / $413.69 / $428.56	Professional	TC	$387.04	$413.69	$428.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $478.26 / $478.26 / $478.26	Facility	26	$478.26	$478.26	$478.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $353.07 / $683.48 / $900.78	Professional		$353.07	$683.48	$900.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.80 / $190.39 / $245.32	Professional	26	$100.80	$190.39	$245.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $248.51 / $489.18 / $655.47	Professional	TC	$248.51	$489.18	$655.47
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $805.76 / $805.76 / $805.76	Facility	26	$805.76	$805.76	$805.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $366.73 / $624.30 / $2,077.84	Professional		$366.73	$624.30	$2,077.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $106.67 / $165.69 / $221.70	Professional	26	$106.67	$165.69	$221.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $281.73 / $449.99 / $2,614.00	Professional	TC	$281.73	$449.99	$2,614.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $275.04 / $283.05 / $478.26	Facility	26	$275.04	$283.05	$478.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $535.09 / $653.97 / $885.21	Professional		$535.09	$653.97	$885.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.11 / $285.73 / $503.58	Professional		$89.11	$285.73	$503.58
United Facility/Professional Professional Modifier Low / Median / High Price $366.73 / $598.74 / $742.94	Professional		$366.73	$598.74	$742.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $106.67 / $175.98 / $216.09	Professional	26	$106.67	$175.98	$216.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $281.73 / $448.91 / $541.79	Professional	TC	$281.73	$448.91	$541.79