Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.36 / $169.92 / $286.42	Facility	26	$47.36	$169.92	$286.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.86 / $146.46 / $891.85	Professional		$125.86	$146.46	$891.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.23 / $77.29 / $146.91	Professional	26	$44.23	$77.29	$146.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.48 / $99.10 / $598.65	Professional	TC	$91.48	$99.10	$598.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $86.42 / $105.00 / $105.00	Professional	26	$86.42	$105.00	$105.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $265.81 / $284.12 / $292.92	Professional		$265.81	$284.12	$292.92
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.79 / $92.21 / $94.53	Professional	26	$82.79	$92.21	$94.53
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $179.53 / $191.90 / $202.68	Professional	TC	$179.53	$191.90	$202.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $272.16 / $272.16 / $272.16	Facility	26	$272.16	$272.16	$272.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.31 / $337.25 / $443.12	Professional		$157.31	$337.25	$443.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.24 / $103.18 / $138.66	Professional	26	$51.24	$103.18	$138.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.00 / $227.15 / $304.45	Professional	TC	$114.00	$227.15	$304.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $219.49 / $219.49 / $219.49	Facility	26	$219.49	$219.49	$219.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $159.05 / $281.62 / $1,019.78	Professional		$159.05	$281.62	$1,019.78
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $46.31 / $96.03 / $310.80	Professional	26	$46.31	$96.03	$310.80
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $112.70 / $193.10 / $708.98	Professional	TC	$112.70	$193.10	$708.98
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $107.56 / $110.70 / $272.16	Facility	26	$107.56	$110.70	$272.16
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.00 / $317.52 / $412.06	Professional		$181.00	$317.52	$412.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.34 / $108.72 / $277.17	Professional		$53.34	$108.72	$277.17
United Facility/Professional Professional Modifier Low / Median / High Price $163.06 / $281.62 / $354.26	Professional		$163.06	$281.62	$354.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.24 / $97.31 / $123.88	Professional	26	$60.24	$97.31	$123.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.70 / $183.14 / $230.38	Professional	TC	$112.70	$183.14	$230.38