Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.44 / $113.41 / $315.14	Facility	26	$34.44	$113.41	$315.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.44 / $194.55 / $429.00	Professional		$87.44	$194.55	$429.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.04 / $77.39 / $122.72	Professional	26	$34.04	$77.39	$122.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.00 / $68.90 / $146.50	Professional	TC	$53.00	$68.90	$146.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.97 / $171.38 / $201.73	Professional		$105.97	$171.38	$201.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.95 / $65.72 / $80.06	Professional	26	$26.95	$65.72	$80.06
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $87.85 / $103.36 / $131.11	Professional	TC	$87.85	$103.36	$131.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $159.50 / $172.22 / $176.53	Professional		$159.50	$172.22	$176.53
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.64 / $67.64 / $69.31	Professional	26	$62.64	$67.64	$69.31
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $96.87 / $104.59 / $107.20	Professional	TC	$96.87	$104.59	$107.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $199.56 / $199.56 / $199.56	Facility	26	$199.56	$199.56	$199.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $200.39 / $268.58	Professional		$81.59	$200.39	$268.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.88 / $79.09 / $101.81	Professional	26	$32.88	$79.09	$101.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.05 / $121.31 / $166.78	Professional	TC	$55.05	$121.31	$166.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $84.08 / $163.00 / $163.00	Facility	26	$84.08	$163.00	$163.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $113.05 / $171.50 / $274.14	Professional		$113.05	$171.50	$274.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $43.86 / $68.73 / $105.92	Professional	26	$43.86	$68.73	$105.92
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $64.30 / $104.48 / $372.64	Professional	TC	$64.30	$104.48	$372.64
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $115.60 / $118.96 / $199.56	Facility	26	$115.60	$118.96	$199.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $166.00 / $197.29 / $249.43	Professional		$166.00	$197.29	$249.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.45 / $85.25 / $168.89	Professional		$38.45	$85.25	$168.89
United Facility/Professional Professional Modifier Low / Median / High Price $108.16 / $175.45 / $219.11	Professional		$108.16	$175.45	$219.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.86 / $68.56 / $88.86	Professional	26	$43.86	$68.56	$88.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.30 / $105.24 / $133.94	Professional	TC	$64.30	$105.24	$133.94