Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $74.13 / $218.78	Facility	26	$48.98	$74.13	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $57.54 / $234.42	Professional		$39.81	$57.54	$234.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $41.69 / $117.49	Professional	26	$20.89	$41.69	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $23.99 / $100.00	Professional	TC	$17.78	$23.99	$100.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $87.10	Professional		$32.36	$47.86	$87.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $41.69 / $57.54	Professional	26	$19.05	$41.69	$57.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $23.44 / $47.86	Professional	TC	$22.91	$23.44	$47.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $83.18 / $87.10	Professional		$77.62	$83.18	$87.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $44.67 / $47.86	Professional	26	$41.69	$44.67	$47.86
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $38.02 / $40.74	Professional	TC	$35.48	$38.02	$40.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Facility	26	$131.83	$131.83	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $97.72 / $131.83	Professional		$35.48	$97.72	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $50.12 / $69.18	Professional	26	$19.05	$50.12	$69.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $43.65 / $63.10	Professional	TC	$16.22	$43.65	$63.10
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Facility	26	$107.15	$107.15	$107.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $83.18 / $501.19	Professional		$53.70	$83.18	$501.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $45.71 / $151.36	Professional	26	$29.51	$45.71	$151.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.90 / $371.54	Professional	TC	$23.99	$38.90	$371.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $97.72 / $147.91	Professional		$85.11	$97.72	$147.91
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $52.48 / $79.43	Professional	26	$46.77	$52.48	$79.43
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $44.67 / $70.79	Professional	TC	$39.81	$44.67	$70.79
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Facility	26	$131.83	$131.83	$131.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $100.00 / $104.71	Professional		$97.72	$100.00	$104.71
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $48.98 / $56.23	Professional	26	$30.90	$48.98	$56.23
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $46.77 / $67.61	Professional	TC	$44.67	$46.77	$67.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $41.69 / $89.13	Professional		$20.89	$41.69	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $75.86 / $109.65	Professional		$53.70	$75.86	$109.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $37.15 / $58.88	Professional	26	$28.18	$37.15	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.02 / $60.26	Professional	TC	$23.99	$38.02	$60.26