Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.32 / $46.15 / $661.46	Facility		$17.32	$46.15	$661.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.28 / $161.31 / $439.37	Facility	26	$29.28	$161.31	$439.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.46 / $124.74 / $210.91	Professional		$45.46	$124.74	$210.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.00 / $45.34 / $124.74	Professional	26	$28.00	$45.34	$124.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $120.99 / $120.99 / $120.99	Professional	50	$120.99	$120.99	$120.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.18 / $36.89 / $53.49	Professional	TC	$16.18	$36.89	$53.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $252.82 / $342.64 / $643.22	Facility		$252.82	$342.64	$643.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.51 / $90.18 / $92.43	Professional		$83.51	$90.18	$92.43
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.38 / $57.64 / $59.07	Professional	26	$53.38	$57.64	$59.07
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.14 / $32.35 / $33.36	Professional	TC	$30.14	$32.35	$33.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $266.16 / $266.16 / $266.16	Facility		$266.16	$266.16	$266.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $170.10 / $170.10 / $170.10	Facility	26	$170.10	$170.10	$170.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.86 / $107.50 / $161.91	Professional		$69.86	$107.50	$161.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.87 / $68.70 / $98.00	Professional	26	$29.87	$68.70	$98.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.51 / $38.79 / $59.99	Professional	TC	$28.51	$38.79	$59.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.46 / $107.35 / $284.04	Facility		$45.46	$107.35	$284.04
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $198.78 / $198.78 / $198.78	Facility	26	$198.78	$198.78	$198.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.98 / $98.64 / $659.45	Professional		$63.98	$98.64	$659.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $36.97 / $60.08 / $335.18	Professional	26	$36.97	$60.08	$335.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.29 / $37.93 / $404.98	Professional	TC	$25.29	$37.93	$404.98
Midlands Facility/Professional Facility Modifier Low / Median / High Price $91.38 / $113.56 / $266.16	Facility		$91.38	$113.56	$266.16
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $165.75 / $170.10 / $170.58	Facility	26	$165.75	$170.10	$170.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $92.49 / $138.53 / $189.54	Professional		$92.49	$138.53	$189.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $124.70 / $157.19 / $200.60	Professional		$124.70	$157.19	$200.60
United Facility/Professional Facility Modifier Low / Median / High Price $110.06 / $197.98 / $277.98	Facility		$110.06	$197.98	$277.98
United Facility/Professional Professional Modifier Low / Median / High Price $60.31 / $98.01 / $159.38	Professional		$60.31	$98.01	$159.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.97 / $59.37 / $89.78	Professional	26	$36.97	$59.37	$89.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.34 / $37.47 / $68.34	Professional	TC	$23.34	$37.47	$68.34