Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $77.62 / $229.09	Facility	26	$31.62	$77.62	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $134.90 / $446.68	Professional		$85.11	$134.90	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $35.48 / $66.07	Professional	26	$22.91	$35.48	$66.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $95.50 / $239.88	Professional	TC	$67.61	$95.50	$239.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Professional		$281.84	$281.84	$281.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $35.48 / $53.70	Professional	26	$19.05	$35.48	$53.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $229.09 / $234.42	Professional		$213.80	$229.09	$234.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $46.77 / $50.12	Professional	26	$44.67	$46.77	$50.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $181.97 / $208.93	Professional	TC	$165.96	$181.97	$208.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Facility	26	$141.25	$141.25	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $234.42 / $363.08	Professional		$95.50	$234.42	$363.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $51.29 / $72.44	Professional	26	$22.91	$51.29	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $169.82 / $295.12	Professional	TC	$83.18	$169.82	$295.12
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $114.82 / $114.82	Facility	26	$114.82	$114.82	$114.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $173.78 / $851.14	Professional		$97.72	$173.78	$851.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $44.67 / $204.17	Professional	26	$30.90	$44.67	$204.17
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $131.83 / $676.08	Professional	TC	$66.07	$131.83	$676.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $275.42 / $416.87	Professional		$234.42	$275.42	$416.87
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $54.95 / $85.11	Professional	26	$48.98	$54.95	$85.11
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $218.78 / $331.13	Professional	TC	$186.21	$218.78	$331.13
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Facility	26	$141.25	$141.25	$141.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $234.42 / $416.87	Professional		$138.04	$234.42	$416.87
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $51.29 / $85.11	Professional	26	$42.66	$51.29	$85.11
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $95.50 / $331.13	Professional	TC	$87.10	$95.50	$331.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $97.72 / $208.93	Professional		$25.70	$97.72	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $169.82 / $263.03	Professional		$97.72	$169.82	$263.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $40.74 / $64.57	Professional	26	$26.92	$40.74	$64.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $128.82 / $208.93	Professional	TC	$79.43	$128.82	$208.93