Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.90 / $491.04 / $1,107.80	Facility		$41.90	$491.04	$1,107.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.95 / $100.52 / $272.01	Facility	26	$28.95	$100.52	$272.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.26 / $73.41 / $213.40	Professional		$53.26	$73.41	$213.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.95 / $66.70 / $174.63	Professional	26	$28.95	$66.70	$174.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.77 / $58.83 / $170.38	Professional	TC	$25.77	$58.83	$170.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.55 / $110.83 / $130.38	Professional		$46.55	$110.83	$130.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.25 / $54.41 / $71.83	Professional	26	$31.25	$54.41	$71.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $287.24 / $389.28 / $730.77	Facility		$287.24	$389.28	$730.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.29 / $108.30 / $111.01	Professional		$100.29	$108.30	$111.01
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.61 / $56.82 / $58.24	Professional	26	$52.61	$56.82	$58.24
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.68 / $50.96 / $52.77	Professional	TC	$47.68	$50.96	$52.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $319.56 / $319.56 / $821.00	Facility		$319.56	$319.56	$821.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.64 / $167.64 / $167.64	Facility	26	$167.64	$167.64	$167.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.39 / $128.97 / $200.38	Professional		$48.39	$128.97	$200.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.71 / $66.48 / $86.30	Professional	26	$27.71	$66.48	$86.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.60 / $57.55 / $98.49	Professional	TC	$22.60	$57.55	$98.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $56.21 / $140.80 / $889.98	Facility		$56.21	$140.80	$889.98
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $261.98 / $261.98 / $261.98	Facility	26	$261.98	$261.98	$261.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $65.31 / $116.01 / $947.00	Professional		$65.31	$116.01	$947.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.15 / $58.36 / $93.29	Professional	26	$38.15	$58.36	$93.29
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.41 / $54.63 / $758.00	Professional	TC	$30.41	$54.63	$758.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $109.72 / $128.97 / $319.56	Facility		$109.72	$128.97	$319.56
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $104.68 / $107.73 / $167.64	Facility	26	$104.68	$107.73	$167.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $109.72 / $128.97 / $268.00	Professional		$109.72	$128.97	$268.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.64 / $61.40 / $390.20	Professional		$32.64	$61.40	$390.20
United Facility/Professional Professional Modifier Low / Median / High Price $65.31 / $116.01 / $194.41	Professional		$65.31	$116.01	$194.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.25 / $58.36 / $75.45	Professional	26	$37.25	$58.36	$75.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.07 / $54.02 / $156.16	Professional	TC	$28.07	$54.02	$156.16