Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.78 / $57.38 / $80.63	Facility	26	$34.78	$57.38	$80.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.26 / $279.00 / $564.00	Professional		$120.26	$279.00	$564.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.11 / $65.69 / $97.91	Professional	26	$34.11	$65.69	$97.91
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $31.98 / $38.42 / $564.00	Professional	52	$31.98	$38.42	$564.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.72 / $133.41 / $260.25	Professional	TC	$83.72	$133.41	$260.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.96 / $129.08 / $230.50	Professional		$97.96	$129.08	$230.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.90 / $64.90 / $81.09	Professional	26	$26.90	$64.90	$81.09
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $25.17 / $70.20 / $70.20	Professional	52	$25.17	$70.20	$70.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $163.92 / $169.66 / $169.66	Professional	TC	$163.92	$169.66	$169.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $221.33 / $236.58 / $244.11	Professional		$221.33	$236.58	$244.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.50 / $67.87 / $69.56	Professional	26	$63.50	$67.87	$69.56
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $157.83 / $168.69 / $175.09	Professional	TC	$157.83	$168.69	$175.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $200.34 / $200.34 / $200.34	Facility	26	$200.34	$200.34	$200.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.16 / $274.12 / $377.18	Professional		$139.16	$274.12	$377.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.13 / $79.15 / $102.78	Professional	26	$42.13	$79.15	$102.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $105.78 / $197.12 / $274.39	Professional	TC	$105.78	$197.12	$274.39
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $163.47 / $163.47 / $163.47	Facility	26	$163.47	$163.47	$163.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $166.09 / $245.86 / $365.59	Professional		$166.09	$245.86	$365.59
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $48.24 / $70.20 / $92.78	Professional	26	$48.24	$70.20	$92.78
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $117.88 / $117.88 / $117.88	Professional	52	$117.88	$117.88	$117.88
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $117.85 / $176.77 / $598.35	Professional	TC	$117.85	$176.77	$598.35
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $121.06 / $124.58 / $200.34	Facility	26	$121.06	$124.58	$200.34
Midlands Facility/Professional Professional Modifier Low / Median / High Price $234.04 / $274.12 / $435.86	Professional		$234.04	$274.12	$435.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.52 / $115.10 / $211.54	Professional		$36.52	$115.10	$211.54
United Facility/Professional Professional Modifier Low / Median / High Price $163.88 / $242.20 / $313.52	Professional		$163.88	$242.20	$313.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.53 / $69.28 / $91.07	Professional	26	$44.53	$69.28	$91.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.74 / $170.53 / $222.45	Professional	TC	$112.74	$170.53	$222.45