Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Facility	26	$72.44	$72.44	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $398.11 / $1,412.54	Professional		$199.53	$398.11	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $114.82 / $190.55	Professional	26	$66.07	$114.82	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $190.55 / $676.08	Professional	TC	$131.83	$190.55	$676.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Professional		$501.19	$501.19	$501.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $60.26 / $169.82	Professional	26	$60.26	$60.26	$169.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $407.38 / $426.58	Professional		$389.05	$407.38	$426.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $138.04 / $144.54	Professional	26	$131.83	$138.04	$144.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $269.15 / $295.12	Professional	TC	$245.47	$269.15	$295.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $416.87 / $416.87 / $416.87	Facility	26	$416.87	$416.87	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $426.58 / $660.69	Professional		$173.78	$426.58	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $158.49 / $218.78	Professional	26	$61.66	$158.49	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $281.84 / $446.68	Professional	TC	$114.82	$281.84	$446.68
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Facility	26	$707.95	$707.95	$707.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $588.84 / $1,479.11	Professional		$281.84	$588.84	$1,479.11
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $147.91 / $478.63	Professional	26	$93.33	$147.91	$478.63
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $398.11 / $1,047.13	Professional	TC	$190.55	$398.11	$1,047.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $489.78 / $758.58	Professional		$426.58	$489.78	$758.58
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $165.96 / $257.04	Professional	26	$144.54	$165.96	$257.04
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $331.13 / $501.19	Professional	TC	$281.84	$331.13	$501.19
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $416.87 / $416.87 / $416.87	Facility	26	$416.87	$416.87	$416.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $501.19 / $758.58	Professional		$426.58	$501.19	$758.58
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $169.82 / $257.04	Professional	26	$144.54	$169.82	$257.04
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $323.59 / $501.19	Professional	TC	$281.84	$323.59	$501.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $158.49 / $371.54	Professional		$75.86	$158.49	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $467.74 / $1,122.02	Professional		$281.84	$467.74	$1,122.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $141.25 / $194.98	Professional	26	$81.28	$141.25	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $331.13 / $954.99	Professional	TC	$190.55	$331.13	$954.99