Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.50 / $70.34 / $190.41	Facility	26	$27.50	$70.34	$190.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.71 / $104.55 / $541.00	Professional		$86.71	$104.55	$541.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.77 / $45.51 / $102.18	Professional	26	$25.77	$45.51	$102.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.79 / $65.68 / $175.51	Professional	TC	$61.79	$65.68	$175.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.77 / $52.46 / $63.91	Professional	26	$37.77	$52.46	$63.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $168.34 / $179.94 / $186.38	Professional		$168.34	$179.94	$186.38
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.93 / $53.38 / $54.71	Professional	26	$49.93	$53.38	$54.71
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $118.42 / $126.58 / $131.36	Professional	TC	$118.42	$126.58	$131.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $157.50 / $157.50 / $157.50	Facility	26	$157.50	$157.50	$157.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $214.20 / $282.16	Professional		$109.44	$214.20	$282.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.10 / $62.42 / $81.45	Professional	26	$33.10	$62.42	$81.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.89 / $144.44 / $200.71	Professional	TC	$68.89	$144.44	$200.71
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $128.65 / $128.65 / $128.65	Facility	26	$128.65	$128.65	$128.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.00 / $175.42 / $648.50	Professional		$104.00	$175.42	$648.50
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.73 / $55.55 / $180.32	Professional	26	$30.73	$55.55	$180.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $72.95 / $118.54 / $468.12	Professional	TC	$72.95	$118.54	$468.12
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $71.22 / $73.30 / $157.50	Facility	26	$71.22	$73.30	$157.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $124.00 / $190.30 / $257.36	Professional		$124.00	$190.30	$257.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $68.98 / $157.49	Professional		$28.18	$68.98	$157.49
United Facility/Professional Professional Modifier Low / Median / High Price $107.95 / $179.25 / $220.67	Professional		$107.95	$179.25	$220.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.00 / $54.86 / $71.55	Professional	26	$35.00	$54.86	$71.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.95 / $118.54 / $151.97	Professional	TC	$72.95	$118.54	$151.97