Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $67.61 / $208.93	Facility	26	$38.90	$67.61	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $162.18 / $407.38	Professional		$93.33	$162.18	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $66.07 / $138.04	Professional	26	$28.84	$66.07	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $93.33 / $407.38	Professional	TC	$63.10	$93.33	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $87.10 / $204.17	Professional		$64.57	$87.10	$204.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $36.31 / $69.18	Professional	26	$25.12	$36.31	$69.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $52.48 / $131.83	Professional	TC	$26.30	$52.48	$131.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $194.98 / $204.17	Professional		$181.97	$194.98	$204.17
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $60.26 / $64.57	Professional	26	$56.23	$60.26	$64.57
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $131.83 / $162.18	Professional	TC	$112.20	$131.83	$162.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $181.97 / $181.97	Facility	26	$181.97	$181.97	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $204.17 / $316.23	Professional		$83.18	$204.17	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $67.61 / $95.50	Professional	26	$26.30	$67.61	$95.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $141.25 / $218.78	Professional	TC	$56.23	$141.25	$218.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $169.82 / $169.82	Facility	26	$169.82	$169.82	$169.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $186.21 / $691.83	Professional		$117.49	$186.21	$691.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $61.66 / $93.33	Professional	26	$39.81	$61.66	$93.33
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $131.83 / $478.63	Professional	TC	$83.18	$131.83	$478.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $229.09 / $354.81	Professional		$199.53	$229.09	$354.81
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $72.44 / $109.65	Professional	26	$63.10	$72.44	$109.65
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $154.88 / $245.47	Professional	TC	$138.04	$154.88	$245.47
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $181.97 / $181.97	Facility	26	$181.97	$181.97	$181.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $177.83 / $245.47	Professional		$169.82	$177.83	$245.47
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $67.61 / $77.62	Professional	26	$57.54	$67.61	$77.62
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $120.23 / $169.82	Professional	TC	$102.33	$120.23	$169.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $81.28 / $208.93	Professional		$33.88	$81.28	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $154.88 / $251.19	Professional		$112.20	$154.88	$251.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $50.12 / $83.18	Professional	26	$38.90	$50.12	$83.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $109.65 / $173.78	Professional	TC	$70.79	$109.65	$173.78