Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.69 / $73.09 / $203.12	Facility	26	$22.69	$73.09	$203.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.99 / $93.13 / $321.32	Professional		$45.99	$93.13	$321.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.01 / $52.84 / $81.95	Professional	26	$18.01	$52.84	$81.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.30 / $49.48 / $107.56	Professional	TC	$23.30	$49.48	$107.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.45 / $83.69 / $93.65	Professional		$38.45	$83.69	$93.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.69 / $32.57 / $52.90	Professional	26	$22.69	$32.57	$52.90
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $47.06 / $48.71 / $48.71	Professional	TC	$47.06	$48.71	$48.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.10 / $90.98 / $94.20	Professional		$85.10	$90.98	$94.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.82 / $44.07 / $45.38	Professional	26	$40.82	$44.07	$45.38
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.93 / $47.34 / $49.02	Professional	TC	$42.93	$47.34	$49.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $130.08 / $130.08 / $130.08	Facility	26	$130.08	$130.08	$130.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.41 / $106.74 / $155.00	Professional		$41.41	$106.74	$155.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.94 / $51.43 / $66.90	Professional	26	$18.94	$51.43	$66.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.78 / $51.85 / $90.58	Professional	TC	$20.78	$51.85	$90.58
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $115.00 / $115.00 / $115.00	Facility	26	$115.00	$115.00	$115.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $59.33 / $93.09 / $181.31	Professional		$59.33	$93.09	$181.31
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $23.38 / $42.14 / $232.81	Professional	26	$23.38	$42.14	$232.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.27 / $49.40 / $398.91	Professional	TC	$28.27	$49.40	$398.91
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $60.58 / $62.35 / $130.08	Facility	26	$60.58	$62.35	$130.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.11 / $107.00 / $164.17	Professional		$93.11	$107.00	$164.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.77 / $46.13 / $94.87	Professional		$24.77	$46.13	$94.87
United Facility/Professional Professional Modifier Low / Median / High Price $55.08 / $96.58 / $114.75	Professional		$55.08	$96.58	$114.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $45.27 / $58.71	Professional	26	$25.29	$45.27	$58.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.10 / $44.31 / $87.32	Professional	TC	$26.10	$44.31	$87.32