Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.25 / $116.61 / $324.04	Facility	26	$35.25	$116.61	$324.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.58 / $165.29 / $433.46	Professional		$79.58	$165.29	$433.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.02 / $83.08 / $188.00	Professional	26	$34.02	$83.08	$188.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.33 / $55.88 / $107.99	Professional	TC	$44.33	$55.88	$107.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $143.38 / $160.43	Professional		$65.88	$143.38	$160.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.01 / $69.78 / $82.14	Professional	26	$27.01	$69.78	$82.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $77.06 / $90.67 / $90.67	Professional	TC	$77.06	$90.67	$90.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.72 / $159.16 / $163.50	Professional		$147.72	$159.16	$163.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.25 / $69.37 / $71.09	Professional	26	$64.25	$69.37	$71.09
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.48 / $89.23 / $92.39	Professional	TC	$83.48	$89.23	$92.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $204.72 / $204.72 / $204.72	Facility	26	$204.72	$204.72	$204.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.45 / $182.89 / $250.16	Professional		$75.45	$182.89	$250.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.11 / $81.36 / $104.72	Professional	26	$34.11	$81.36	$104.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.09 / $106.04 / $145.44	Professional	TC	$46.09	$106.04	$145.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $163.47 / $163.47 / $163.47	Facility	26	$163.47	$163.47	$163.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $103.96 / $156.01 / $242.47	Professional		$103.96	$156.01	$242.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $45.12 / $71.50 / $108.92	Professional	26	$45.12	$71.50	$108.92
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $57.71 / $86.56 / $351.46	Professional	TC	$57.71	$86.56	$351.46
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $119.33 / $122.80 / $204.72	Facility	26	$119.33	$122.80	$204.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $161.63 / $182.89 / $230.26	Professional		$161.63	$182.89	$230.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.44 / $79.97 / $160.69	Professional		$39.44	$79.97	$160.69
United Facility/Professional Professional Modifier Low / Median / High Price $98.39 / $158.00 / $204.98	Professional		$98.39	$158.00	$204.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.12 / $70.31 / $91.41	Professional	26	$45.12	$70.31	$91.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.27 / $88.44 / $107.91	Professional	TC	$53.27	$88.44	$107.91