Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $91.20 / $281.84	Facility	26	$64.57	$91.20	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $154.88	Professional		$54.95	$70.79	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $28.84 / $72.44	Professional	26	$23.99	$28.84	$72.44
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $66.07 / $213.80 / $257.04	Professional	50	$66.07	$213.80	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $39.81 / $83.18	Professional	TC	$28.84	$39.81	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $50.12 / $53.70	Professional		$47.86	$50.12	$53.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $21.88 / $21.88	Professional	26	$21.88	$21.88	$21.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $125.89 / $131.83	Professional		$117.49	$125.89	$131.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $56.23 / $60.26	Professional	26	$52.48	$56.23	$60.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $69.18 / $70.79	Professional	TC	$64.57	$69.18	$70.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $169.82 / $169.82	Facility	26	$169.82	$169.82	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $144.54 / $204.17	Professional		$54.95	$144.54	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $61.66 / $89.13	Professional	26	$23.99	$61.66	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $75.86 / $114.82	Professional	TC	$29.51	$75.86	$114.82
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $134.90 / $134.90	Facility	26	$134.90	$134.90	$134.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $104.71 / $501.19	Professional		$75.86	$104.71	$501.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $47.86 / $323.59	Professional	26	$32.36	$47.86	$323.59
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $60.26 / $323.59	Professional	TC	$38.90	$60.26	$323.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $144.54 / $229.09	Professional		$128.82	$144.54	$229.09
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $66.07 / $102.33	Professional	26	$57.54	$66.07	$102.33
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $77.62 / $128.82	Professional	TC	$70.79	$77.62	$128.82
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $169.82 / $169.82	Facility	26	$169.82	$169.82	$169.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $147.91 / $158.49	Professional		$131.83	$147.91	$158.49
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $58.88 / $102.33	Professional	26	$46.77	$58.88	$102.33
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $85.11 / $89.13	Professional	TC	$77.62	$85.11	$89.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $177.83 / $204.17	Professional		$141.25	$177.83	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $102.33 / $154.88	Professional		$75.86	$102.33	$154.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $45.71 / $70.79	Professional	26	$32.36	$45.71	$70.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $56.23 / $85.11	Professional	TC	$38.90	$56.23	$85.11