Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.84 / $498.75 / $800.29	Facility		$105.84	$498.75	$800.29
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.84 / $63.45 / $230.74	Facility	26	$25.84	$63.45	$230.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.52 / $135.13 / $468.15	Professional		$99.52	$135.13	$468.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.05 / $55.64 / $141.68	Professional	26	$25.05	$55.64	$141.68
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $49.76 / $52.11 / $337.21	Professional	52	$49.76	$52.11	$337.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.15 / $99.30 / $472.75	Professional	TC	$76.15	$99.30	$472.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.23 / $172.08 / $238.30	Professional		$78.23	$172.08	$238.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.92 / $45.58 / $60.04	Professional	26	$19.92	$45.58	$60.04
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $128.72 / $151.44 / $178.26	Professional	TC	$128.72	$151.44	$178.26
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 $188.50 / $203.53 / $208.63	Professional		$188.50	$203.53	$208.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.39 / $50.10 / $51.68	Professional	26	$46.39	$50.10	$51.68
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $142.09 / $153.44 / $157.28	Professional	TC	$142.09	$153.44	$157.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $600.00 / $600.00 / $600.66	Facility		$600.00	$600.00	$600.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.84 / $147.84 / $147.84	Facility	26	$147.84	$147.84	$147.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.64 / $240.12 / $321.92	Professional		$96.64	$240.12	$321.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.26 / $59.29 / $76.59	Professional	26	$24.26	$59.29	$76.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.62 / $180.82 / $245.32	Professional	TC	$82.62	$180.82	$245.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $126.05 / $404.49 / $752.70	Facility		$126.05	$404.49	$752.70
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $122.00 / $122.00 / $122.00	Facility	26	$122.00	$122.00	$122.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $121.85 / $204.34 / $726.73	Professional		$121.85	$204.34	$726.73
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.10 / $51.42 / $78.72	Professional	26	$33.10	$51.42	$78.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $88.75 / $155.13 / $554.94	Professional	TC	$88.75	$155.13	$554.94
Midlands Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $240.12 / $384.82	Facility		$186.21	$240.12	$384.82
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $85.37 / $87.85 / $147.84	Facility	26	$85.37	$87.85	$147.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $149.00 / $233.42 / $289.89	Professional		$149.00	$233.42	$289.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.83 / $102.80 / $199.51	Professional		$28.83	$102.80	$199.51
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 $121.85 / $204.39 / $263.02	Professional		$121.85	$204.39	$263.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.88 / $51.10 / $66.61	Professional	26	$32.88	$51.10	$66.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.75 / $155.69 / $196.42	Professional	TC	$88.75	$155.69	$196.42