Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.82 / $95.30 / $272.52	Facility	26	$29.82	$95.30	$272.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.63 / $155.79 / $380.00	Professional		$76.63	$155.79	$380.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.16 / $67.15 / $129.00	Professional	26	$29.16	$67.15	$129.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.81 / $62.21 / $286.00	Professional	TC	$46.81	$62.21	$286.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $145.46 / $150.63	Professional		$87.28	$145.46	$150.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.09 / $56.88 / $69.30	Professional	26	$27.09	$56.88	$69.30
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $115.81 / $115.81 / $115.81	Professional	TC	$115.81	$115.81	$115.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.19 / $150.30 / $154.06	Professional		$139.19	$150.30	$154.06
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.64 / $57.92 / $59.64	Professional	26	$53.64	$57.92	$59.64
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.54 / $92.37 / $94.68	Professional	TC	$85.54	$92.37	$94.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $170.94 / $170.94 / $170.94	Facility	26	$170.94	$170.94	$170.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.11 / $174.89 / $235.62	Professional		$71.11	$174.89	$235.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.31 / $67.73 / $88.24	Professional	26	$28.31	$67.73	$88.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.08 / $107.14 / $147.38	Professional	TC	$48.08	$107.14	$147.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $139.28 / $139.28 / $139.28	Facility	26	$139.28	$139.28	$139.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.74 / $152.87 / $244.35	Professional		$100.74	$152.87	$244.35
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $37.96 / $59.69 / $91.09	Professional	26	$37.96	$59.69	$91.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $56.80 / $92.31 / $329.23	Professional	TC	$56.80	$92.31	$329.23
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $97.74 / $100.58 / $170.94	Facility	26	$97.74	$100.58	$170.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $152.00 / $174.89 / $217.53	Professional		$152.00	$174.89	$217.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.27 / $75.48 / $148.37	Professional		$33.27	$75.48	$148.37
United Facility/Professional Professional Modifier Low / Median / High Price $94.76 / $152.88 / $197.43	Professional		$94.76	$152.88	$197.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.96 / $60.95 / $76.90	Professional	26	$37.96	$60.95	$76.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.80 / $93.39 / $118.35	Professional	TC	$56.80	$93.39	$118.35