Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.36 / $146.56 / $416.41	Facility	26	$45.36	$146.56	$416.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.35 / $199.51 / $519.00	Professional		$111.35	$199.51	$519.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $108.45 / $190.00	Professional	26	$42.60	$108.45	$190.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.98 / $84.76 / $160.26	Professional	TC	$65.98	$84.76	$160.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $126.22 / $217.74 / $256.31	Professional		$126.22	$217.74	$256.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.37 / $89.82 / $105.72	Professional	26	$45.37	$89.82	$105.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $52.53 / $127.91 / $127.91	Professional	TC	$52.53	$127.91	$127.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $202.18 / $218.31 / $223.78	Professional		$202.18	$218.31	$223.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.14 / $88.70 / $90.92	Professional	26	$82.14	$88.70	$90.92
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.04 / $129.62 / $132.86	Professional	TC	$120.04	$129.62	$132.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $261.72 / $261.72 / $261.72	Facility	26	$261.72	$261.72	$261.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.94 / $253.82 / $340.34	Professional		$112.94	$253.82	$340.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.21 / $103.48 / $133.81	Professional	26	$43.21	$103.48	$133.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.34 / $150.34 / $206.53	Professional	TC	$68.34	$150.34	$206.53
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $211.96 / $211.96 / $211.96	Facility	26	$211.96	$211.96	$211.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $138.07 / $214.76 / $342.15	Professional		$138.07	$214.76	$342.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $58.04 / $90.27 / $138.26	Professional	26	$58.04	$90.27	$138.26
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $82.73 / $127.55 / $470.82	Professional	TC	$82.73	$127.55	$470.82
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $151.37 / $155.78 / $261.72	Facility	26	$151.37	$155.78	$261.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $172.00 / $253.82 / $316.80	Professional		$172.00	$253.82	$316.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.77 / $110.33 / $214.45	Professional		$50.77	$110.33	$214.45
United Facility/Professional Professional Modifier Low / Median / High Price $138.07 / $221.72 / $279.70	Professional		$138.07	$221.72	$279.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.04 / $86.49 / $117.59	Professional	26	$58.04	$86.49	$117.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.03 / $130.05 / $162.12	Professional	TC	$80.03	$130.05	$162.12