Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.46 / $108.83 / $302.43	Facility	26	$33.46	$108.83	$302.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.51 / $104.98 / $463.00	Professional		$79.51	$104.98	$463.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.67 / $74.95 / $87.93	Professional	26	$32.67	$74.95	$87.93
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $85.35 / $154.06 / $723.00	Professional	50	$85.35	$154.06	$723.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.83 / $70.84 / $156.37	Professional	TC	$63.83	$70.84	$156.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.11 / $183.46 / $240.18	Professional		$76.11	$183.46	$240.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.74 / $46.10 / $116.99	Professional	26	$25.74	$46.10	$116.99
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $114.16 / $176.13 / $335.26	Professional	50	$114.16	$176.13	$335.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $157.62 / $157.62 / $157.62	Professional	TC	$157.62	$157.62	$157.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $175.97 / $190.02 / $194.77	Professional		$175.97	$190.02	$194.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.46 / $65.28 / $66.92	Professional	26	$60.46	$65.28	$66.92
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $115.52 / $124.73 / $127.86	Professional	TC	$115.52	$124.73	$127.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $192.66 / $192.66 / $192.66	Facility	26	$192.66	$192.66	$192.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.09 / $222.22 / $298.64	Professional		$90.09	$222.22	$298.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.64 / $76.09 / $98.90	Professional	26	$31.64	$76.09	$98.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.44 / $146.11 / $199.74	Professional	TC	$58.44	$146.11	$199.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $157.44 / $157.44 / $157.44	Facility	26	$157.44	$157.44	$157.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.67 / $181.81 / $290.62	Professional		$120.67	$181.81	$290.62
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $64.23 / $102.68	Professional	26	$42.60	$64.23	$102.68
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $78.06 / $117.57 / $187.94	Professional	TC	$78.06	$117.57	$187.94
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $118.40 / $121.85 / $192.66	Facility	26	$118.40	$121.85	$192.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $192.53 / $222.22 / $284.14	Professional		$192.53	$222.22	$284.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $92.84 / $171.20	Professional		$35.67	$92.84	$171.20
United Facility/Professional Professional Modifier Low / Median / High Price $120.67 / $193.78 / $244.46	Professional		$120.67	$193.78	$244.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.30 / $67.51 / $86.30	Professional	26	$44.30	$67.51	$86.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.06 / $125.37 / $158.16	Professional	TC	$78.06	$125.37	$158.16