Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.65 / $210.14 / $354.21	Facility	26	$38.65	$210.14	$354.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.59 / $128.59 / $702.02	Professional		$128.59	$128.59	$702.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.85 / $95.59 / $99.96	Professional	26	$37.85	$95.59	$99.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.93 / $90.74 / $475.35	Professional	TC	$47.93	$90.74	$475.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $237.09 / $253.41 / $259.75	Professional		$237.09	$253.41	$259.75
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.54 / $74.34 / $76.20	Professional	26	$69.54	$74.34	$76.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $167.53 / $179.08 / $183.56	Professional	TC	$167.53	$179.08	$183.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $219.42 / $219.42 / $219.42	Facility	26	$219.42	$219.42	$219.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.57 / $293.89 / $403.36	Professional		$136.57	$293.89	$403.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.00 / $91.83 / $115.39	Professional	26	$69.00	$91.83	$115.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.90 / $208.43 / $287.98	Professional	TC	$72.90	$208.43	$287.98
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $196.24 / $196.24 / $196.24	Facility	26	$196.24	$196.24	$196.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $90.13 / $181.47 / $886.70	Professional		$90.13	$181.47	$886.70
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $49.95 / $75.76 / $414.43	Professional	26	$49.95	$75.76	$414.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.78 / $145.41 / $639.54	Professional	TC	$23.78	$145.41	$639.54
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $135.09 / $139.03 / $219.42	Facility	26	$135.09	$139.03	$219.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $113.78 / $246.04 / $354.26	Professional		$113.78	$246.04	$354.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $43.76 / $106.19 / $251.19	Professional		$43.76	$106.19	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $77.23 / $218.56 / $275.72	Professional		$77.23	$218.56	$275.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.62 / $75.51 / $97.13	Professional	26	$46.62	$75.51	$97.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.78 / $145.41 / $190.55	Professional	TC	$23.78	$145.41	$190.55