Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $64.57 / $87.10	Facility	26	$45.71	$64.57	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $138.04 / $371.54	Professional		$63.10	$138.04	$371.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $63.10 / $102.33	Professional	26	$34.67	$63.10	$102.33
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	52	$95.50	$95.50	$95.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $107.15 / $234.42	Professional	TC	$77.62	$107.15	$234.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $97.72 / $144.54	Professional		$93.33	$97.72	$144.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $43.65 / $77.62	Professional	26	$28.84	$43.65	$77.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $158.49 / $199.53	Professional	TC	$56.23	$158.49	$199.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $229.09 / $239.88	Professional		$218.78	$229.09	$239.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $72.44 / $74.13	Professional	26	$67.61	$72.44	$74.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $158.49 / $165.96	Professional	TC	$147.91	$158.49	$165.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $239.88 / $380.19	Professional		$97.72	$239.88	$380.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $81.28 / $112.20	Professional	26	$30.90	$81.28	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $162.18 / $263.03	Professional	TC	$67.61	$162.18	$263.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $173.78 / $173.78 / $173.78	Facility	26	$173.78	$173.78	$173.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $223.87 / $354.81	Professional		$151.36	$223.87	$354.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $72.44 / $97.72	Professional	26	$48.98	$72.44	$97.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $141.25 / $562.34	Professional	TC	$102.33	$141.25	$562.34
Midlands Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $269.15 / $426.58	Professional		$239.88	$269.15	$426.58
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $85.11 / $128.82	Professional	26	$74.13	$85.11	$128.82
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 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $281.84 / $426.58	Professional		$239.88	$281.84	$426.58
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $87.10 / $128.82	Professional	26	$74.13	$87.10	$128.82
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $194.98 / $295.12	Professional	TC	$162.18	$194.98	$295.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $89.13 / $208.93	Professional		$39.81	$89.13	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $186.21 / $309.03	Professional		$151.36	$186.21	$309.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $58.88 / $97.72	Professional	26	$45.71	$58.88	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $128.82 / $213.80	Professional	TC	$102.33	$128.82	$213.80