Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.05 / $493.25 / $853.52	Facility		$122.05	$493.25	$853.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.86 / $67.15 / $243.79	Facility	26	$26.86	$67.15	$243.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $92.03 / $356.25 / $749.55	Facility	TC	$92.03	$356.25	$749.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.64 / $111.76 / $407.97	Professional		$82.64	$111.76	$407.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $40.86 / $115.78	Professional	26	$25.26	$40.86	$115.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.44 / $80.89 / $153.44	Professional	TC	$54.44	$80.89	$153.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.06 / $87.26 / $203.87	Professional		$68.06	$87.26	$203.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.69 / $47.38 / $62.40	Professional	26	$20.69	$47.38	$62.40
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $92.02 / $108.26 / $108.26	Professional	TC	$92.02	$108.26	$108.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $252.82 / $371.88 / $643.22	Facility		$252.82	$371.88	$643.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.06 / $160.96 / $165.28	Professional		$149.06	$160.96	$165.28
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.25 / $52.10 / $53.71	Professional	26	$48.25	$52.10	$53.71
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.83 / $108.88 / $111.59	Professional	TC	$100.83	$108.88	$111.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.07 / $475.02 / $600.00	Facility		$85.07	$475.02	$600.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $153.72 / $153.72 / $153.72	Facility	26	$153.72	$153.72	$153.72
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $321.30 / $321.30 / $321.30	Facility	TC	$321.30	$321.30	$321.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.31 / $188.63 / $254.04	Professional		$76.31	$188.63	$254.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.94 / $61.64 / $79.51	Professional	26	$22.94	$61.64	$79.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.07 / $126.99 / $174.53	Professional	TC	$51.07	$126.99	$174.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $132.38 / $333.02 / $771.88	Facility		$132.38	$333.02	$771.88
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $125.66 / $125.66 / $131.10	Facility	26	$125.66	$125.66	$131.10
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $267.93 / $698.88 / $837.20	Facility	TC	$267.93	$698.88	$837.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.41 / $166.42 / $568.24	Professional		$102.41	$166.42	$568.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.76 / $52.66 / $81.84	Professional	26	$35.76	$52.66	$81.84
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $68.23 / $110.88 / $390.02	Professional	TC	$68.23	$110.88	$390.02
Midlands Facility/Professional Facility Modifier Low / Median / High Price $99.24 / $185.02 / $296.32	Facility		$99.24	$185.02	$296.32
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $91.30 / $93.96 / $153.72	Facility	26	$91.30	$93.96	$153.72
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $104.60 / $260.94 / $321.30	Facility	TC	$104.60	$260.94	$321.30
Midlands Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $185.02 / $233.64	Professional		$153.00	$185.02	$233.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $29.96 / $88.01 / $158.94	Professional		$29.96	$88.01	$158.94
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 $102.41 / $164.87 / $207.46	Professional		$102.41	$164.87	$207.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.18 / $53.59 / $69.23	Professional	26	$34.18	$53.59	$69.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.23 / $110.88 / $142.15	Professional	TC	$68.23	$110.88	$142.15