Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.36 / $575.63 / $1,098.85	Facility		$137.36	$575.63	$1,098.85
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.79 / $91.83 / $333.96	Facility	26	$36.79	$91.83	$333.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.89 / $245.34 / $558.00	Professional		$109.89	$245.34	$558.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.20 / $79.33 / $176.00	Professional	26	$35.20	$79.33	$176.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.11 / $127.52 / $454.00	Professional	TC	$73.11	$127.52	$454.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $116.05 / $207.22 / $252.46	Professional		$116.05	$207.22	$252.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.41 / $39.60 / $73.67	Professional	26	$28.41	$39.60	$73.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $83.36 / $141.63 / $141.71	Professional	TC	$83.36	$141.63	$141.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $370.81 / $502.54 / $943.40	Facility		$370.81	$502.54	$943.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.19 / $215.08 / $220.46	Professional		$199.19	$215.08	$220.46
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.51 / $71.81 / $73.62	Professional	26	$66.51	$71.81	$73.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $132.66 / $143.25 / $146.84	Professional	TC	$132.66	$143.25	$146.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.07 / $600.00 / $634.74	Facility		$85.07	$600.00	$634.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $211.98 / $211.98 / $211.98	Facility	26	$211.98	$211.98	$211.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.23 / $253.26 / $337.43	Professional		$112.23	$253.26	$337.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.97 / $84.47 / $108.60	Professional	26	$34.97	$84.47	$108.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.97 / $168.79 / $228.83	Professional	TC	$76.97	$168.79	$228.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $139.10 / $317.51 / $971.28	Facility		$139.10	$317.51	$971.28
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $172.60 / $172.60 / $172.60	Facility	26	$172.60	$172.60	$172.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $138.16 / $222.61 / $379.19	Professional		$138.16	$222.61	$379.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $47.49 / $72.16 / $113.40	Professional	26	$47.49	$72.16	$113.40
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $90.74 / $147.34 / $518.02	Professional	TC	$90.74	$147.34	$518.02
Midlands Facility/Professional Facility Modifier Low / Median / High Price $99.24 / $246.22 / $411.78	Facility		$99.24	$246.22	$411.78
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $124.21 / $127.83 / $211.98	Facility	26	$124.21	$127.83	$211.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $210.00 / $250.49 / $313.39	Professional		$210.00	$250.49	$313.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.18 / $112.94 / $211.36	Professional		$41.18	$112.94	$211.36
United Facility/Professional Professional Modifier Low / Median / High Price $138.16 / $224.50 / $279.88	Professional		$138.16	$224.50	$279.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.49 / $73.40 / $96.19	Professional	26	$47.49	$73.40	$96.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.67 / $139.16 / $183.69	Professional	TC	$90.67	$139.16	$183.69