Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $19.95 / $75.86	Facility	26	$14.79	$19.95	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $67.61 / $165.96	Professional		$33.11	$67.61	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $9.77 / $28.84	Professional	26	$8.71	$9.77	$28.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $39.81 / $87.10	Professional	TC	$24.55	$39.81	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $30.20 / $75.86	Professional		$22.91	$30.20	$75.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.55 / $19.95	Professional	26	$7.08	$9.55	$19.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $46.77 / $57.54	Professional	TC	$21.88	$46.77	$57.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $70.79 / $74.13	Professional		$67.61	$70.79	$74.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $17.78 / $18.62	Professional	26	$16.60	$17.78	$18.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $53.70 / $63.10	Professional	TC	$48.98	$53.70	$63.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	26	$52.48	$52.48	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $89.13 / $162.18	Professional		$30.90	$89.13	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $19.95 / $26.92	Professional	26	$8.51	$19.95	$26.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $66.07 / $144.54	Professional	TC	$25.12	$66.07	$144.54
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $79.43 / $79.43	Facility	26	$79.43	$79.43	$79.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $72.44 / $223.87	Professional		$43.65	$72.44	$223.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $17.78 / $23.99	Professional	26	$11.48	$17.78	$23.99
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $52.48 / $489.78	Professional	TC	$32.36	$52.48	$489.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $83.18 / $134.90	Professional		$74.13	$83.18	$134.90
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $20.89 / $31.62	Professional	26	$18.20	$20.89	$31.62
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $64.57 / $102.33	Professional	TC	$54.95	$64.57	$102.33
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	26	$52.48	$52.48	$52.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $134.90 / $239.88	Professional		$77.62	$134.90	$239.88
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $21.38 / $31.62	Professional	26	$20.89	$21.38	$31.62
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $102.33 / $208.93	Professional	TC	$57.54	$102.33	$208.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $30.90 / $66.07	Professional		$9.77	$30.90	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $70.79 / $128.82	Professional		$40.74	$70.79	$128.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.14 / $23.99	Professional	26	$8.91	$15.14	$23.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $52.48 / $102.33	Professional	TC	$30.20	$52.48	$102.33