Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.67 / $146.94 / $416.41	Facility	26	$45.67	$146.94	$416.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.84 / $280.00 / $583.00	Professional		$127.84	$280.00	$583.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.08 / $107.06 / $205.00	Professional	26	$44.08	$107.06	$205.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.17 / $99.56 / $206.81	Professional	TC	$82.17	$99.56	$206.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.85 / $249.87 / $294.12	Professional		$144.85	$249.87	$294.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.97 / $90.44 / $106.46	Professional	26	$35.97	$90.44	$106.46
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $135.52 / $159.43 / $159.43	Professional	TC	$135.52	$159.43	$159.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $232.91 / $251.50 / $257.79	Professional		$232.91	$251.50	$257.79
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.70 / $89.29 / $91.53	Professional	26	$82.70	$89.29	$91.53
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $150.19 / $162.18 / $166.22	Professional	TC	$150.19	$162.18	$166.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $263.52 / $263.52 / $263.52	Facility	26	$263.52	$263.52	$263.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.51 / $291.37 / $392.70	Professional		$118.51	$291.37	$392.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.54 / $104.17 / $134.78	Professional	26	$43.54	$104.17	$134.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.61 / $187.20 / $257.92	Professional	TC	$85.61	$187.20	$257.92
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $213.45 / $213.45 / $213.45	Facility	26	$213.45	$213.45	$213.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $160.60 / $247.67 / $394.69	Professional		$160.60	$247.67	$394.69
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $58.04 / $91.16 / $139.21	Professional	26	$58.04	$91.16	$139.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $99.71 / $162.03 / $574.48	Professional	TC	$99.71	$162.03	$574.48
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $153.76 / $158.24 / $263.52	Facility	26	$153.76	$158.24	$263.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $233.00 / $286.07 / $362.15	Professional		$233.00	$286.07	$362.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.12 / $120.74 / $246.25	Professional		$51.12	$120.74	$246.25
United Facility/Professional Professional Modifier Low / Median / High Price $157.75 / $253.32 / $319.58	Professional		$157.75	$253.32	$319.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.04 / $91.98 / $117.59	Professional	26	$58.04	$91.98	$117.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.71 / $160.11 / $201.99	Professional	TC	$99.71	$160.11	$201.99