Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.99 / $102.67 / $278.62	Facility	26	$30.99	$102.67	$278.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.48 / $171.79 / $406.00	Professional		$118.48	$171.79	$406.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.53 / $43.05 / $169.00	Professional	26	$30.53	$43.05	$169.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.95 / $97.24 / $127.52	Professional	TC	$87.95	$97.24	$127.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.52 / $42.91 / $72.93	Professional	26	$24.52	$42.91	$72.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $230.33 / $253.99 / $262.97	Professional		$230.33	$253.99	$262.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.04 / $61.60 / $63.14	Professional	26	$57.04	$61.60	$63.14
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $175.00 / $192.99 / $199.81	Professional	TC	$175.00	$192.99	$199.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.80 / $181.80 / $181.80	Facility	26	$181.80	$181.80	$181.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.07 / $298.07 / $480.02	Professional		$132.07	$298.07	$480.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.87 / $71.22 / $93.08	Professional	26	$28.87	$71.22	$93.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $103.88 / $226.87 / $390.18	Professional	TC	$103.88	$226.87	$390.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $147.81 / $147.81 / $147.81	Facility	26	$147.81	$147.81	$147.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $156.12 / $235.06 / $898.89	Professional		$156.12	$235.06	$898.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $39.78 / $61.89 / $95.37	Professional	26	$39.78	$61.89	$95.37
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $109.97 / $159.50 / $695.99	Professional	TC	$109.97	$159.50	$695.99
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $106.72 / $109.83 / $181.80	Facility	26	$106.72	$109.83	$181.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $169.00 / $263.07 / $371.56	Professional		$169.00	$263.07	$371.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.79 / $153.80 / $297.51	Professional		$35.79	$153.80	$297.51
United Facility/Professional Professional Modifier Low / Median / High Price $156.12 / $243.72 / $374.50	Professional		$156.12	$243.72	$374.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.58 / $62.59 / $80.18	Professional	26	$39.58	$62.59	$80.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.97 / $188.38 / $312.67	Professional	TC	$109.97	$188.38	$312.67