Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $120.23 / $1,122.02	Facility		$41.69	$120.23	$1,122.02
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $64.57 / $281.84	Facility	26	$36.31	$64.57	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $81.28 / $223.87	Professional		$51.29	$81.28	$223.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $54.95 / $173.78	Professional	26	$28.18	$54.95	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $46.77 / $169.82	Professional	TC	$22.91	$46.77	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $72.44 / $131.83	Professional		$41.69	$72.44	$131.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $33.88 / $64.57	Professional	26	$22.91	$33.88	$64.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $52.48 / $63.10	Professional	TC	$52.48	$52.48	$63.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $416.87 / $1,096.48	Facility		$288.40	$416.87	$1,096.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $107.15 / $112.20	Professional		$100.00	$107.15	$112.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $56.23 / $60.26	Professional	26	$52.48	$56.23	$60.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $50.12 / $52.48	Professional	TC	$47.86	$50.12	$52.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $812.83	Facility		$316.23	$316.23	$812.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	26	$165.96	$165.96	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $128.82 / $199.53	Professional		$46.77	$128.82	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $63.10 / $89.13	Professional	26	$24.55	$63.10	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $57.54 / $123.03	Professional	TC	$22.39	$57.54	$123.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $288.40 / $933.25	Facility		$54.95	$288.40	$933.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	26	$263.03	$263.03	$263.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $114.82 / $954.99	Professional		$64.57	$114.82	$954.99
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $56.23 / $371.54	Professional	26	$37.15	$56.23	$371.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $53.70 / $758.58	Professional	TC	$28.18	$53.70	$758.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $125.89 / $199.53	Professional		$112.20	$125.89	$199.53
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $66.07 / $102.33	Professional	26	$58.88	$66.07	$102.33
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $57.54 / $97.72	Professional	TC	$52.48	$57.54	$97.72
Midlands Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	26	$165.96	$165.96	$165.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $165.96 / $269.15	Professional		$123.03	$165.96	$269.15
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $54.95 / $70.79	Professional	26	$42.66	$54.95	$70.79
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $97.72 / $213.80	Professional	TC	$57.54	$97.72	$213.80
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $12,022.64 / $12,022.64 / $14,125.38	Facility		$12,022.64	$12,022.64	$14,125.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $169.82 / $489.78	Professional		$151.36	$169.82	$489.78
United Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $97.72 / $141.25	Facility		$35.48	$97.72	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $109.65 / $257.04	Professional		$64.57	$109.65	$257.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $47.86 / $77.62	Professional	26	$35.48	$47.86	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $51.29 / $218.78	Professional	TC	$28.18	$51.29	$218.78