Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.50 / $63.54 / $246.85	Facility	26	$27.50	$63.54	$246.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.78 / $78.00 / $220.59	Professional		$49.78	$78.00	$220.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.50 / $61.90 / $117.36	Professional	26	$27.50	$61.90	$117.36
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $27.50 / $56.80 / $228.00	Professional	52	$27.50	$56.80	$228.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.28 / $47.11 / $141.00	Professional	TC	$22.28	$47.11	$141.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.45 / $53.30 / $95.16	Professional		$40.45	$53.30	$95.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.17 / $51.15 / $63.91	Professional	26	$21.17	$51.15	$63.91
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $10.31 / $28.98 / $28.98	Professional	52	$10.31	$28.98	$28.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $42.72 / $44.22 / $44.22	Professional	TC	$42.72	$44.22	$44.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.04 / $97.31 / $103.04	Professional		$91.04	$97.31	$103.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.93 / $53.38 / $56.92	Professional	26	$49.93	$53.38	$56.92
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.11 / $43.96 / $45.63	Professional	TC	$41.11	$43.96	$45.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $157.50 / $157.50 / $157.50	Facility	26	$157.50	$157.50	$157.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.21 / $112.72 / $152.22	Professional		$57.21	$112.72	$152.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.10 / $63.13 / $81.45	Professional	26	$33.10	$63.13	$81.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.22 / $51.24 / $70.78	Professional	TC	$27.22	$51.24	$70.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $128.65 / $128.65 / $128.65	Facility	26	$128.65	$128.65	$128.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.77 / $100.80 / $150.77	Professional		$67.77	$100.80	$150.77
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $37.92 / $55.48 / $72.93	Professional	26	$37.92	$55.48	$72.93
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $48.80 / $48.80 / $48.80	Professional	52	$48.80	$48.80	$48.80
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.85 / $44.77 / $151.88	Professional	TC	$29.85	$44.77	$151.88
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $99.31 / $102.21 / $157.50	Facility	26	$99.31	$102.21	$157.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.29 / $112.72 / $177.73	Professional		$97.29	$112.72	$177.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.83 / $44.02 / $87.55	Professional		$23.83	$44.02	$87.55
United Facility/Professional Professional Modifier Low / Median / High Price $62.56 / $100.45 / $129.63	Professional		$62.56	$100.45	$129.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.01 / $55.48 / $72.93	Professional	26	$35.01	$55.48	$72.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.85 / $44.45 / $56.34	Professional	TC	$29.85	$44.45	$56.34