Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $859.00 / $2,292.09 / $3,359.56	Facility	26	$859.00	$2,292.09	$3,359.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,709.16 / $4,100.00 / $11,080.00	Professional		$1,709.16	$4,100.00	$11,080.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $402.56 / $906.62 / $2,063.00	Professional	26	$402.56	$906.62	$2,063.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,306.59 / $1,306.59 / $8,751.70	Professional	TC	$1,306.59	$1,306.59	$8,751.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $3,450.78 / $3,450.78 / $3,450.78	Professional		$3,450.78	$3,450.78	$3,450.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $407.38 / $954.44 / $954.44	Professional	26	$407.38	$954.44	$954.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,176.82 / $3,395.67 / $3,480.57	Professional		$3,176.82	$3,395.67	$3,480.57
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $741.69 / $792.77 / $812.60	Professional	26	$741.69	$792.77	$812.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $2,435.13 / $2,602.90 / $2,667.96	Professional	TC	$2,435.13	$2,602.90	$2,667.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2,339.52 / $2,339.52 / $2,339.52	Facility	26	$2,339.52	$2,339.52	$2,339.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,186.00 / $4,275.53 / $5,455.11	Professional		$3,186.00	$4,275.53	$5,455.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $659.00 / $975.83 / $1,219.79	Professional	26	$659.00	$975.83	$1,219.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2,527.00 / $3,277.34 / $4,235.32	Professional	TC	$2,527.00	$3,277.34	$4,235.32
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $886.59 / $1,924.04 / $1,924.04	Facility	26	$886.59	$1,924.04	$1,924.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,320.88 / $3,481.32 / $13,450.23	Professional		$2,320.88	$3,481.32	$13,450.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $495.83 / $805.72 / $2,845.07	Professional	26	$495.83	$805.72	$2,845.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $1,783.73 / $2,731.85 / $9,015.64	Professional	TC	$1,783.73	$2,731.85	$9,015.64
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $1,292.23 / $1,329.87 / $2,339.52	Facility	26	$1,292.23	$1,329.87	$2,339.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,660.00 / $3,849.40 / $4,994.30	Professional		$2,660.00	$3,849.40	$4,994.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $468.88 / $1,656.60 / $3,378.59	Professional		$468.88	$1,656.60	$3,378.59
United Facility/Professional Professional Modifier Low / Median / High Price $2,320.88 / $3,589.24 / $4,463.22	Professional		$2,320.88	$3,589.24	$4,463.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $495.83 / $803.11 / $1,032.98	Professional	26	$495.83	$803.11	$1,032.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,783.73 / $2,675.60 / $3,430.25	Professional	TC	$1,783.73	$2,675.60	$3,430.25