Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.30 / $294.99 / $831.54	Facility	26	$91.30	$294.99	$831.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $333.12 / $764.58 / $1,776.00	Professional		$333.12	$764.58	$1,776.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.29 / $152.01 / $293.94	Professional	26	$89.29	$152.01	$293.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $241.82 / $485.96 / $648.30	Professional	TC	$241.82	$485.96	$648.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $261.83 / $750.57 / $750.57	Professional		$261.83	$750.57	$750.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $70.54 / $174.72 / $212.86	Professional	26	$70.54	$174.72	$212.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $176.55 / $176.55 / $441.36	Professional	TC	$176.55	$176.55	$441.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $603.99 / $645.60 / $666.24	Professional		$603.99	$645.60	$666.24
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $167.06 / $178.58 / $188.99	Professional	26	$167.06	$178.58	$188.99
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $436.92 / $467.01 / $483.63	Professional	TC	$436.92	$467.01	$483.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $526.98 / $526.98 / $526.98	Facility	26	$526.98	$526.98	$526.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $395.19 / $765.38 / $1,008.41	Professional		$395.19	$765.38	$1,008.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.20 / $209.47 / $269.56	Professional	26	$110.20	$209.47	$269.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $283.97 / $551.70 / $738.85	Professional	TC	$283.97	$551.70	$738.85
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $887.84 / $887.84 / $887.84	Facility	26	$887.84	$887.84	$887.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $446.72 / $706.21 / $2,326.86	Professional		$446.72	$706.21	$2,326.86
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $117.27 / $190.24 / $281.39	Professional	26	$117.27	$190.24	$281.39
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $319.68 / $512.65 / $2,909.00	Professional	TC	$319.68	$512.65	$2,909.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $302.16 / $310.95 / $526.98	Facility	26	$302.16	$310.95	$526.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $610.37 / $751.79 / $992.66	Professional		$610.37	$751.79	$992.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.04 / $317.56 / $561.44	Professional		$97.04	$317.56	$561.44
United Facility/Professional Professional Modifier Low / Median / High Price $412.36 / $686.39 / $859.08	Professional		$412.36	$686.39	$859.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $117.27 / $191.73 / $237.56	Professional	26	$117.27	$191.73	$237.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $306.37 / $507.82 / $614.78	Professional	TC	$306.37	$507.82	$614.78