Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.78 / $49.48 / $86.24	Facility	26	$36.78	$49.48	$86.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.40 / $139.38 / $549.60	Professional		$66.40	$139.38	$549.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.22 / $72.67 / $93.15	Professional	26	$36.22	$72.67	$93.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $95.26 / $95.26 / $95.26	Professional	52	$95.26	$95.26	$95.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.77 / $114.82 / $246.36	Professional	TC	$79.77	$114.82	$246.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.89 / $126.35 / $225.62	Professional		$95.89	$126.35	$225.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.41 / $68.64 / $85.77	Professional	26	$28.41	$68.64	$85.77
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $155.22 / $160.65 / $160.65	Professional	TC	$155.22	$160.65	$160.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.03 / $231.97 / $238.40	Professional		$217.03	$231.97	$238.40
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.78 / $72.43 / $74.25	Professional	26	$67.78	$72.43	$74.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $149.25 / $159.53 / $165.71	Professional	TC	$149.25	$159.53	$165.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.78 / $213.78 / $213.78	Facility	26	$213.78	$213.78	$213.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.58 / $269.52 / $368.46	Professional		$136.58	$269.52	$368.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.43 / $84.48 / $108.60	Professional	26	$44.43	$84.48	$108.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.82 / $187.15 / $259.86	Professional	TC	$100.82	$187.15	$259.86
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $172.60 / $172.60 / $172.60	Facility	26	$172.60	$172.60	$172.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $162.88 / $242.11 / $810.58	Professional		$162.88	$242.11	$810.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.44 / $74.18 / $109.07	Professional	26	$51.44	$74.18	$109.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $111.45 / $167.17 / $567.92	Professional	TC	$111.45	$167.17	$567.92
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $128.01 / $131.74 / $213.78	Facility	26	$128.01	$131.74	$213.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $228.68 / $269.52 / $426.83	Professional		$228.68	$269.52	$426.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $112.73 / $208.36	Professional		$38.65	$112.73	$208.36
United Facility/Professional Professional Modifier Low / Median / High Price $160.04 / $234.67 / $307.49	Professional		$160.04	$234.67	$307.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.48 / $75.33 / $97.11	Professional	26	$47.48	$75.33	$97.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.45 / $155.13 / $210.38	Professional	TC	$111.45	$155.13	$210.38