Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.99 / $798.73 / $1,258.40	Facility		$97.99	$798.73	$1,258.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.99 / $79.93 / $134.74	Facility	26	$14.99	$79.93	$134.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.98 / $97.99 / $479.00	Professional		$90.98	$97.99	$479.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.19 / $16.54 / $84.00	Professional	26	$14.19	$16.54	$84.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.31 / $83.01 / $475.35	Professional	TC	$76.31	$83.01	$475.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.51 / $27.51 / $27.51	Professional	26	$27.51	$27.51	$27.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $289.33 / $392.13 / $736.13	Facility		$289.33	$392.13	$736.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $174.38 / $191.47 / $196.27	Professional		$174.38	$191.47	$196.27
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.60 / $29.50 / $31.03	Professional	26	$27.60	$29.50	$31.03
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $145.41 / $161.97 / $166.03	Professional	TC	$145.41	$161.97	$166.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $565.08 / $565.08 / $1,218.00	Facility		$565.08	$565.08	$1,218.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.06 / $87.06 / $87.06	Facility	26	$87.06	$87.06	$87.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.85 / $216.33 / $298.64	Professional		$97.85	$216.33	$298.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.68 / $33.72 / $43.63	Professional	26	$17.68	$33.72	$43.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.94 / $183.59 / $255.01	Professional	TC	$80.94	$183.59	$255.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $97.99 / $167.89 / $460.18	Facility		$97.99	$167.89	$460.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $108.61 / $176.49 / $687.89	Professional		$108.61	$176.49	$687.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.14 / $31.10 / $150.00	Professional	26	$19.14	$31.10	$150.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $88.04 / $145.38 / $591.79	Professional	TC	$88.04	$145.38	$591.79
Midlands Facility/Professional Facility Modifier Low / Median / High Price $156.19 / $216.33 / $291.31	Facility		$156.19	$216.33	$291.31
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $50.63 / $52.11 / $87.06	Facility	26	$50.63	$52.11	$87.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $139.00 / $200.30 / $263.02	Professional		$139.00	$200.30	$263.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.48 / $96.82 / $184.95	Professional		$17.48	$96.82	$184.95
United Facility/Professional Facility Modifier Low / Median / High Price $188.46 / $188.46 / $199.54	Facility		$188.46	$188.46	$199.54
United Facility/Professional Professional Modifier Low / Median / High Price $108.61 / $176.49 / $225.28	Professional		$108.61	$176.49	$225.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.14 / $31.48 / $39.13	Professional	26	$19.14	$31.48	$39.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.47 / $145.38 / $182.89	Professional	TC	$89.47	$145.38	$182.89