Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.17 / $93.25 / $260.66	Facility	26	$29.17	$93.25	$260.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.85 / $138.40 / $585.14	Professional		$94.85	$138.40	$585.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.17 / $67.93 / $140.94	Professional	26	$29.17	$67.93	$140.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.68 / $75.65 / $105.25	Professional	TC	$65.68	$75.65	$105.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.98 / $100.15 / $217.88	Professional		$74.98	$100.15	$217.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.18 / $53.41 / $58.40	Professional	26	$29.18	$53.41	$58.40
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $123.20 / $127.51 / $127.51	Professional	TC	$123.20	$127.51	$127.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $166.13 / $183.21 / $189.69	Professional		$166.13	$183.21	$189.69
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.45 / $56.64 / $58.34	Professional	26	$52.45	$56.64	$58.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $115.27 / $127.12 / $131.61	Professional	TC	$115.27	$127.12	$131.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.16 / $167.16 / $167.16	Facility	26	$167.16	$167.16	$167.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.64 / $217.32 / $292.83	Professional		$78.64	$217.32	$292.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.73 / $66.95 / $86.30	Professional	26	$24.73	$66.95	$86.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.30 / $150.36 / $206.53	Professional	TC	$54.30	$150.36	$206.53
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $136.22 / $136.22 / $136.22	Facility	26	$136.22	$136.22	$136.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.95 / $160.25 / $654.87	Professional		$117.95	$160.25	$654.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $37.13 / $56.06 / $89.24	Professional	26	$37.13	$56.06	$89.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $79.36 / $110.11 / $461.63	Professional	TC	$79.36	$110.11	$461.63
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $99.30 / $102.19 / $167.16	Facility	26	$99.30	$102.19	$167.16
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.94 / $205.04 / $270.45	Professional		$134.94	$205.04	$270.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.64 / $91.88 / $182.42	Professional		$31.64	$91.88	$182.42
United Facility/Professional Professional Modifier Low / Median / High Price $117.95 / $160.25 / $238.94	Professional		$117.95	$160.25	$238.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.13 / $58.20 / $75.22	Professional	26	$37.13	$58.20	$75.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.34 / $129.78 / $163.72	Professional	TC	$74.34	$129.78	$163.72