Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.76 / $106.89 / $288.62	Facility	26	$40.76	$106.89	$288.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.45 / $270.75 / $737.00	Professional		$121.45	$270.75	$737.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.93 / $73.44 / $97.85	Professional	26	$34.93	$73.44	$97.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.23 / $91.98 / $247.33	Professional	TC	$79.23	$91.98	$247.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.05 / $95.03 / $95.03	Professional	26	$76.05	$95.03	$95.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $240.53 / $257.10 / $265.48	Professional		$240.53	$257.10	$265.48
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.70 / $79.84 / $81.84	Professional	26	$74.70	$79.84	$81.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $165.81 / $177.24 / $183.96	Professional	TC	$165.81	$177.24	$183.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $235.68 / $235.68 / $235.68	Facility	26	$235.68	$235.68	$235.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $152.69 / $302.89 / $400.46	Professional		$152.69	$302.89	$400.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.89 / $89.67 / $120.23	Professional	26	$48.89	$89.67	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.06 / $209.35 / $280.22	Professional	TC	$108.06	$209.35	$280.22
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $190.76 / $190.76 / $190.76	Facility	26	$190.76	$190.76	$190.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $148.00 / $252.58 / $927.52	Professional		$148.00	$252.58	$927.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $44.07 / $83.34 / $268.38	Professional	26	$44.07	$83.34	$268.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $102.86 / $167.15 / $659.08	Professional	TC	$102.86	$167.15	$659.08
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $106.66 / $109.76 / $235.68	Facility	26	$106.66	$109.76	$235.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $177.00 / $271.92 / $368.51	Professional		$177.00	$271.92	$368.51
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.52 / $125.24 / $223.55	Professional		$42.52	$125.24	$223.55
United Facility/Professional Professional Modifier Low / Median / High Price $155.44 / $252.58 / $323.83	Professional		$155.44	$252.58	$323.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.88 / $83.34 / $107.47	Professional	26	$41.88	$83.34	$107.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.86 / $158.65 / $210.27	Professional	TC	$102.86	$158.65	$210.27