Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.63 / $580.15 / $977.89	Facility	26	$108.63	$580.15	$977.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $272.57 / $335.52 / $1,723.34	Professional		$272.57	$335.52	$1,723.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.63 / $252.12 / $563.00	Professional	26	$108.63	$252.12	$563.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.94 / $213.12 / $1,053.10	Professional	TC	$163.94	$213.12	$1,053.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $116.51 / $192.44 / $253.46	Professional	26	$116.51	$192.44	$253.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $502.81 / $537.46 / $564.22	Professional		$502.81	$537.46	$564.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $198.97 / $212.68 / $222.21	Professional	26	$198.97	$212.68	$222.21
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $303.85 / $324.77 / $339.36	Professional	TC	$303.85	$324.77	$339.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $627.60 / $627.60 / $627.60	Facility	26	$627.60	$627.60	$627.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $381.11 / $676.71 / $960.90	Professional		$381.11	$676.71	$960.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.26 / $248.57 / $320.95	Professional	26	$131.26	$248.57	$320.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $278.14 / $408.93 / $639.95	Professional	TC	$278.14	$408.93	$639.95
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,056.00 / $1,056.00 / $1,056.00	Facility	26	$1,056.00	$1,056.00	$1,056.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $438.70 / $728.66 / $2,091.94	Professional		$438.70	$728.66	$2,091.94
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $136.36 / $228.12 / $711.82	Professional	26	$136.36	$228.12	$711.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $288.25 / $487.80 / $1,773.11	Professional	TC	$288.25	$487.80	$1,773.11
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $355.75 / $366.11 / $627.60	Facility	26	$355.75	$366.11	$627.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $530.66 / $700.24 / $903.15	Professional		$530.66	$700.24	$903.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $123.88 / $345.31 / $602.09	Professional		$123.88	$345.31	$602.09
United Facility/Professional Professional Modifier Low / Median / High Price $404.95 / $728.66 / $820.37	Professional		$404.95	$728.66	$820.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $138.88 / $223.01 / $281.33	Professional	26	$138.88	$223.01	$281.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $266.07 / $487.80 / $623.77	Professional	TC	$266.07	$487.80	$623.77