Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $309.03 / $645.65	Facility		$87.10	$309.03	$645.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $66.07 / $199.53	Facility	26	$38.90	$66.07	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $114.82 / $380.19	Professional		$54.95	$114.82	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $72.44 / $154.88	Professional	26	$30.20	$72.44	$154.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $75.86 / $190.55 / $645.65	Professional	50	$75.86	$190.55	$645.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $63.10 / $257.04	Professional	TC	$46.77	$63.10	$257.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $87.10 / $154.88	Professional		$64.57	$87.10	$154.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $36.31 / $64.57	Professional	26	$24.55	$36.31	$64.57
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $128.82 / $128.82 / $288.40	Professional	50	$128.82	$128.82	$288.40
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $95.50 / $102.33	Professional	TC	$39.81	$95.50	$102.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $331.13 / $645.65	Facility		$251.19	$331.13	$645.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $154.88 / $162.18	Professional		$144.54	$154.88	$162.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $60.26 / $64.57	Professional	26	$56.23	$60.26	$64.57
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $95.50 / $100.00	Professional	TC	$89.13	$95.50	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $467.74	Facility		$323.59	$323.59	$467.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $177.83 / $177.83	Facility	26	$177.83	$177.83	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $181.97 / $251.19	Professional		$66.07	$181.97	$251.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $69.18 / $93.33	Professional	26	$26.30	$69.18	$93.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $112.20 / $158.49	Professional	TC	$40.74	$112.20	$158.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $302.00 / $537.03	Facility		$107.15	$302.00	$537.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	26	$147.91	$147.91	$147.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $151.36 / $316.23	Professional		$97.72	$151.36	$316.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $61.66 / $83.18	Professional	26	$39.81	$61.66	$83.18
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $218.78 / $229.09 / $229.09	Professional	50	$218.78	$229.09	$229.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $93.33 / $338.84	Professional	TC	$58.88	$93.33	$338.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $181.97 / $288.40	Professional		$162.18	$181.97	$288.40
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $70.79 / $109.65	Professional	26	$61.66	$70.79	$109.65
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $112.20 / $177.83	Professional	TC	$100.00	$112.20	$177.83
Midlands Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Facility		$467.74	$467.74	$467.74
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $177.83 / $177.83	Facility	26	$177.83	$177.83	$177.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $190.55 / $288.40	Professional		$162.18	$190.55	$288.40
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $72.44 / $109.65	Professional	26	$61.66	$72.44	$109.65
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $114.82 / $177.83	Professional	TC	$100.00	$114.82	$177.83
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $616.60 / $645.65	Facility		$549.54	$616.60	$645.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $69.18 / $151.36	Professional		$33.11	$69.18	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $97.72 / $204.17	Facility		$57.54	$97.72	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $123.03 / $204.17	Professional		$97.72	$123.03	$204.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $50.12 / $81.28	Professional	26	$38.02	$50.12	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $75.86 / $120.23	Professional	TC	$58.88	$75.86	$120.23