Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.48 / $77.75 / $282.52	Facility	26	$31.48	$77.75	$282.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.33 / $181.57 / $541.00	Professional		$99.33	$181.57	$541.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.75 / $70.55 / $135.66	Professional	26	$29.75	$70.55	$135.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.86 / $83.28 / $414.00	Professional	TC	$65.86	$83.28	$414.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.80 / $194.58 / $229.04	Professional		$112.80	$194.58	$229.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.17 / $55.56 / $63.02	Professional	26	$24.17	$55.56	$63.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $54.37 / $132.41 / $132.41	Professional	TC	$54.37	$132.41	$132.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.68 / $195.09 / $199.97	Professional		$180.68	$195.09	$199.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.67 / $61.20 / $62.96	Professional	26	$56.67	$61.20	$62.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $124.01 / $133.90 / $137.25	Professional	TC	$124.01	$133.90	$137.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $180.60 / $180.60 / $180.60	Facility	26	$180.60	$180.60	$180.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.10 / $228.30 / $307.37	Professional		$92.10	$228.30	$307.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.68 / $72.28 / $93.08	Professional	26	$26.68	$72.28	$93.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.28 / $156.02 / $214.29	Professional	TC	$62.28	$156.02	$214.29
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $171.00 / $171.00 / $171.00	Facility	26	$171.00	$171.00	$171.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.26 / $194.00 / $333.59	Professional		$123.26	$194.00	$333.59
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.08 / $62.65 / $95.95	Professional	26	$40.08	$62.65	$95.95
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $135.16 / $479.00	Professional	TC	$83.18	$135.16	$479.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $106.04 / $109.13 / $180.60	Facility	26	$106.04	$109.13	$180.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $169.00 / $223.45 / $281.70	Professional		$169.00	$223.45	$281.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.14 / $106.35 / $191.76	Professional		$35.14	$106.35	$191.76
United Facility/Professional Professional Modifier Low / Median / High Price $123.26 / $198.16 / $249.71	Professional		$123.26	$198.16	$249.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.08 / $62.80 / $81.20	Professional	26	$40.08	$62.80	$81.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $133.58 / $168.51	Professional	TC	$83.18	$133.58	$168.51