Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $371.54 / $1,318.26	Facility		$41.69	$371.54	$1,318.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $56.23 / $239.88	Facility	26	$33.11	$56.23	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $151.36 / $478.63	Professional		$67.61	$151.36	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $57.54 / $147.91	Professional	26	$24.55	$57.54	$147.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $95.50 / $389.05	Professional	TC	$75.86	$95.50	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $87.10 / $208.93	Professional		$74.13	$87.10	$208.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $29.51 / $53.70	Professional	26	$20.89	$29.51	$53.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $75.86 / $75.86	Professional	TC	$75.86	$75.86	$75.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $588.84 / $1,202.26	Facility		$323.59	$588.84	$1,202.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $208.93 / $218.78	Professional		$194.98	$208.93	$218.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $48.98 / $51.29	Professional	26	$45.71	$48.98	$51.29
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $162.18 / $208.93	Professional	TC	$151.36	$162.18	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $630.96	Facility		$363.08	$363.08	$630.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	26	$147.91	$147.91	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $251.19 / $338.84	Professional		$91.20	$251.19	$338.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $61.66 / $77.62	Professional	26	$23.99	$61.66	$77.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $190.55 / $263.03	Professional	TC	$61.66	$190.55	$263.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $512.86 / $1,230.27	Facility		$114.82	$512.86	$1,230.27
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $134.90 / $134.90	Facility	26	$134.90	$134.90	$134.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $151.36 / $275.42	Professional		$81.28	$151.36	$275.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $40.74 / $77.62	Professional	26	$31.62	$40.74	$77.62
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $112.20 / $194.98	Professional	TC	$51.29	$112.20	$194.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $239.88 / $389.05	Professional		$223.87	$239.88	$389.05
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $63.10 / $89.13	Professional	26	$56.23	$63.10	$89.13
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $186.21 / $295.12	Professional	TC	$162.18	$186.21	$295.12
Midlands Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Facility		$630.96	$630.96	$630.96
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	26	$147.91	$147.91	$147.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Professional		$251.19	$251.19	$251.19
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $58.88 / $58.88	Professional	26	$58.88	$58.88	$58.88
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $194.98 / $194.98	Professional	TC	$194.98	$194.98	$194.98
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $2,089.30	Facility		$2,089.30	$2,089.30	$2,089.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $162.18 / $316.23	Professional		$102.33	$162.18	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $151.36 / $263.03	Professional		$104.71	$151.36	$263.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $43.65 / $70.79	Professional	26	$30.20	$43.65	$70.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $112.20 / $194.98	Professional	TC	$77.62	$112.20	$194.98