Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.92 / $389.06 / $655.80	Facility	26	$79.92	$389.06	$655.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $394.03 / $501.43 / $2,844.13	Professional		$394.03	$501.43	$2,844.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.87 / $179.96 / $399.00	Professional	26	$78.87	$179.96	$399.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $342.68 / $342.68 / $2,446.57	Professional	TC	$342.68	$342.68	$2,446.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $894.37 / $894.37 / $894.37	Professional		$894.37	$894.37	$894.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $149.29 / $158.47 / $186.55	Professional	26	$149.29	$158.47	$186.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $771.30 / $824.44 / $845.04	Professional		$771.30	$824.44	$845.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $145.33 / $155.34 / $159.22	Professional	26	$145.33	$155.34	$159.22
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $625.98 / $669.10 / $685.83	Professional	TC	$625.98	$669.10	$685.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $458.40 / $458.40 / $458.40	Facility	26	$458.40	$458.40	$458.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $756.60 / $1,038.05 / $1,304.15	Professional		$756.60	$1,038.05	$1,304.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.00 / $190.59 / $238.53	Professional	26	$129.00	$190.59	$238.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $640.78 / $842.47 / $1,065.61	Professional	TC	$640.78	$842.47	$1,065.61
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,357.70 / $1,357.70 / $1,357.70	Facility	26	$1,357.70	$1,357.70	$1,357.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $542.13 / $885.26 / $4,499.00	Professional		$542.13	$885.26	$4,499.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $97.42 / $158.30 / $1,350.00	Professional	26	$97.42	$158.30	$1,350.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $449.65 / $726.48 / $3,149.00	Professional	TC	$449.65	$726.48	$3,149.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $255.50 / $262.94 / $458.40	Facility	26	$255.50	$262.94	$458.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $639.00 / $990.98 / $1,307.65	Professional		$639.00	$990.98	$1,307.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $91.46 / $387.83 / $804.84	Professional		$91.46	$387.83	$804.84
United Facility/Professional Professional Modifier Low / Median / High Price $542.13 / $885.26 / $1,163.00	Professional		$542.13	$885.26	$1,163.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.42 / $158.30 / $202.95	Professional	26	$97.42	$158.30	$202.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $460.82 / $726.48 / $960.05	Professional	TC	$460.82	$726.48	$960.05