Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.21 / $85.23 / $236.85	Facility	26	$26.21	$85.23	$236.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.38 / $112.65 / $283.36	Professional		$55.38	$112.65	$283.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.72 / $56.92 / $108.63	Professional	26	$25.72	$56.92	$108.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.17 / $62.72 / $94.41	Professional	TC	$29.17	$62.72	$94.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.82 / $113.39 / $133.40	Professional		$47.82	$113.39	$133.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.58 / $46.77 / $65.01	Professional	26	$26.58	$46.77	$65.01
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $60.98 / $60.98 / $71.78	Professional	TC	$60.98	$60.98	$71.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.66 / $109.91 / $113.63	Professional		$102.66	$109.91	$113.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.64 / $51.43 / $52.72	Professional	26	$47.64	$51.43	$52.72
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.13 / $58.82 / $60.90	Professional	TC	$54.13	$58.82	$60.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $151.80 / $151.80 / $151.80	Facility	26	$151.80	$151.80	$151.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.47 / $129.51 / $176.47	Professional		$49.47	$129.51	$176.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.38 / $60.15 / $78.54	Professional	26	$22.38	$60.15	$78.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.98 / $64.33 / $107.00	Professional	TC	$25.98	$64.33	$107.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $124.11 / $124.11 / $131.10	Facility	26	$124.11	$124.11	$131.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.80 / $110.63 / $562.97	Professional		$70.80	$110.63	$562.97
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.74 / $51.68 / $186.58	Professional	26	$33.74	$51.68	$186.58
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $35.53 / $61.26 / $399.92	Professional	TC	$35.53	$61.26	$399.92
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $89.95 / $92.57 / $151.80	Facility	26	$89.95	$92.57	$151.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.31 / $131.38 / $173.93	Professional		$112.31	$131.38	$173.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $29.38 / $54.78 / $115.97	Professional		$29.38	$54.78	$115.97
United Facility/Professional Professional Modifier Low / Median / High Price $66.54 / $110.48 / $138.63	Professional		$66.54	$110.48	$138.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.74 / $52.40 / $68.36	Professional	26	$33.74	$52.40	$68.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.79 / $60.08 / $87.55	Professional	TC	$32.79	$60.08	$87.55