Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.48 / $71.73 / $202.27	Facility	26	$31.48	$71.73	$202.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.64 / $61.24 / $196.00	Professional		$28.64	$61.24	$196.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.21 / $52.06 / $129.00	Professional	26	$18.21	$52.06	$129.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.44 / $10.97 / $86.32	Professional	TC	$8.44	$10.97	$86.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.49 / $65.08 / $136.00	Professional		$46.49	$65.08	$136.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.42 / $54.00 / $62.37	Professional	26	$24.42	$54.00	$62.37
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $54.54 / $57.92 / $57.95	Professional	TC	$54.54	$57.92	$57.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.65 / $114.66 / $120.70	Professional		$82.65	$114.66	$120.70
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.11 / $60.78 / $62.93	Professional	26	$55.11	$60.78	$62.93
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.03 / $54.88 / $57.77	Professional	TC	$23.03	$54.88	$57.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.20 / $181.20 / $181.20	Facility	26	$181.20	$181.20	$181.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.32 / $123.75 / $186.17	Professional		$43.32	$123.75	$186.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.67 / $62.21 / $93.08	Professional	26	$23.67	$62.21	$93.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.48 / $69.61 / $93.08	Professional	TC	$23.48	$69.61	$93.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $131.10 / $148.36 / $148.36	Facility	26	$131.10	$148.36	$148.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.62 / $80.81 / $134.35	Professional		$41.62	$80.81	$134.35
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.39 / $46.39 / $69.42	Professional	26	$28.39	$46.39	$69.42
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $13.23 / $38.93 / $74.87	Professional	TC	$13.23	$38.93	$74.87
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $74.90 / $77.08 / $181.20	Facility	26	$74.90	$77.08	$181.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $69.69 / $120.24 / $148.28	Professional		$69.69	$120.24	$148.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.04 / $57.28 / $111.78	Professional		$32.04	$57.28	$111.78
United Facility/Professional Professional Modifier Low / Median / High Price $41.62 / $80.66 / $130.63	Professional		$41.62	$80.66	$130.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.39 / $45.24 / $66.73	Professional	26	$28.39	$45.24	$66.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.23 / $38.93 / $72.81	Professional	TC	$13.23	$38.93	$72.81