Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $79.43 / $234.42	Facility	26	$56.23	$79.43	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $89.13 / $354.81	Professional		$51.29	$89.13	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $47.86 / $141.25	Professional	26	$23.44	$47.86	$141.25
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $57.54 / $100.00 / $446.68	Professional	52	$57.54	$100.00	$446.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $48.98 / $131.83	Professional	TC	$25.12	$48.98	$131.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $46.77 / $141.25	Professional		$43.65	$46.77	$141.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $32.36 / $61.66	Professional	26	$20.42	$32.36	$61.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $22.91 / $56.23	Professional	TC	$22.91	$22.91	$56.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $104.71 / $109.65	Professional		$97.72	$104.71	$109.65
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $50.12 / $52.48	Professional	26	$46.77	$50.12	$52.48
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $56.23 / $128.82	Professional	TC	$51.29	$56.23	$128.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $151.36 / $151.36	Facility	26	$151.36	$151.36	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $125.89 / $199.53	Professional		$45.71	$125.89	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $52.48 / $77.62	Professional	26	$21.88	$52.48	$77.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $67.61 / $125.89	Professional	TC	$23.99	$67.61	$125.89
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $123.03 / $123.03	Facility	26	$123.03	$123.03	$123.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $117.49 / $446.68	Professional		$89.13	$117.49	$446.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $47.86 / $263.03	Professional	26	$30.90	$47.86	$263.03
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $56.23 / $56.23 / $56.23	Professional	52	$56.23	$56.23	$56.23
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $74.13 / $398.11	Professional	TC	$54.95	$74.13	$398.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $125.89 / $199.53	Professional		$109.65	$125.89	$199.53
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $60.26 / $91.20	Professional	26	$52.48	$60.26	$91.20
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $66.07 / $134.90	Professional	TC	$56.23	$66.07	$134.90
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $151.36 / $151.36	Facility	26	$151.36	$151.36	$151.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $138.04 / $141.25	Professional		$125.89	$138.04	$141.25
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $52.48 / $64.57	Professional	26	$43.65	$52.48	$64.57
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $87.10 / $93.33	Professional	TC	$64.57	$87.10	$93.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $56.23 / $125.89	Professional		$28.84	$56.23	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $112.20 / $181.97	Professional		$89.13	$112.20	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $42.66 / $66.07	Professional	26	$30.90	$42.66	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $63.10 / $114.82	Professional	TC	$54.95	$63.10	$114.82