Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $91.20 / $275.42	Facility	26	$66.07	$91.20	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $107.15 / $457.09	Professional		$51.29	$107.15	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $40.74 / $154.88	Professional	26	$24.55	$40.74	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.91 / $26.30 / $91.20	Professional	TC	$8.91	$26.30	$91.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $41.69 / $60.26	Professional		$33.11	$41.69	$60.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $42.66 / $72.44	Professional	26	$31.62	$42.66	$72.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $7.76 / $7.76 / $7.76	Professional	TC	$7.76	$7.76	$7.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $97.72 / $104.71	Professional		$42.66	$97.72	$104.71
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $79.43 / $83.18	Professional	26	$70.79	$79.43	$83.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $20.42 / $85.11	Professional	TC	$18.62	$20.42	$85.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $239.88 / $239.88 / $239.88	Facility	26	$239.88	$239.88	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $125.89 / $199.53	Professional		$42.66	$125.89	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $81.28 / $125.89	Professional	26	$30.90	$81.28	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $8.32 / $25.12 / $125.89	Professional	TC	$8.32	$25.12	$125.89
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $194.98 / $194.98 / $194.98	Facility	26	$194.98	$194.98	$194.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $125.89 / $562.34	Professional		$87.10	$125.89	$562.34
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $48.98 / $263.03	Professional	26	$35.48	$48.98	$263.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $87.10 / $426.58	Professional	TC	$46.77	$87.10	$426.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $125.89 / $199.53	Professional		$104.71	$125.89	$199.53
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $83.18 / $144.54	Professional	26	$66.07	$83.18	$144.54
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $25.12 / $125.89	Professional	TC	$20.42	$25.12	$125.89
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $239.88 / $239.88 / $239.88	Facility	26	$239.88	$239.88	$239.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $128.82 / $181.97	Professional		$120.23	$128.82	$181.97
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $97.72 / $144.54	Professional	26	$41.69	$97.72	$144.54
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $36.31 / $123.03	Professional	TC	$23.44	$36.31	$123.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $48.98 / $112.20	Professional		$11.22	$48.98	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $213.80	Professional		$87.10	$117.49	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $46.77 / $87.10	Professional	26	$35.48	$46.77	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $70.79 / $158.49	Professional	TC	$21.38	$70.79	$158.49