Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $70.79 / $181.97	Facility	26	$40.74	$70.79	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $75.86 / $257.04	Professional		$32.36	$75.86	$257.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $53.70 / $162.18	Professional	26	$19.95	$53.70	$162.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $263.03 / $263.03 / $263.03	Professional	50	$263.03	$263.03	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.91 / $26.92 / $93.33	Professional	TC	$8.91	$26.92	$93.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $64.57 / $134.90	Professional		$45.71	$64.57	$134.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $37.15 / $61.66	Professional	26	$24.55	$37.15	$61.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $24.55 / $60.26	Professional	TC	$21.88	$24.55	$60.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $114.82 / $120.23	Professional		$77.62	$114.82	$120.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $60.26 / $63.10	Professional	26	$54.95	$60.26	$63.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $54.95 / $57.54	Professional	TC	$22.91	$54.95	$57.54
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 $35.48 / $120.23 / $190.55	Professional		$35.48	$120.23	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $61.66 / $95.50	Professional	26	$23.44	$61.66	$95.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $61.66 / $95.50	Professional	TC	$11.48	$61.66	$95.50
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $147.91 / $147.91	Facility	26	$131.83	$147.91	$147.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $72.44 / $363.08	Professional		$38.90	$72.44	$363.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $54.95 / $102.33	Professional	26	$28.18	$54.95	$102.33
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $36.31 / $213.80	Professional	TC	$12.30	$36.31	$213.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $128.82 / $218.78	Professional		$120.23	$128.82	$218.78
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $63.10 / $112.20	Professional	26	$50.12	$63.10	$112.20
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $69.18 / $107.15	Professional	TC	$57.54	$69.18	$107.15
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 $42.66 / $144.54 / $218.78	Professional		$42.66	$144.54	$218.78
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $74.13 / $112.20	Professional	26	$28.84	$74.13	$112.20
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $69.18 / $107.15	Professional	TC	$14.13	$69.18	$107.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $58.88 / $117.49	Professional		$30.90	$58.88	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $69.18 / $117.49	Professional		$38.90	$69.18	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $35.48 / $66.07	Professional	26	$25.12	$35.48	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $36.31 / $66.07	Professional	TC	$12.30	$36.31	$66.07