Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.67 / $309.27 / $521.30	Facility	26	$58.67	$309.27	$521.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.70 / $467.48 / $1,476.75	Professional		$117.70	$467.48	$1,476.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.90 / $253.95 / $855.17	Professional	26	$57.90	$253.95	$855.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.80 / $59.80 / $389.70	Professional	TC	$59.80	$59.80	$389.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $231.64 / $231.64 / $231.64	Professional		$231.64	$231.64	$231.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $109.75 / $116.50 / $137.13	Professional	26	$109.75	$116.50	$137.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.97 / $234.06 / $239.91	Professional		$218.97	$234.06	$239.91
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $106.84 / $114.20 / $117.05	Professional	26	$106.84	$114.20	$117.05
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.14 / $119.86 / $122.86	Professional	TC	$112.14	$119.86	$122.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $337.02 / $337.02 / $337.02	Facility	26	$337.02	$337.02	$337.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.15 / $290.31 / $371.37	Professional		$237.15	$290.31	$371.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.00 / $140.40 / $175.50	Professional	26	$102.00	$140.40	$175.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.44 / $149.53 / $195.86	Professional	TC	$121.44	$149.53	$195.86
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $347.58 / $347.58 / $347.58	Facility	26	$347.58	$347.58	$347.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $169.18 / $247.17 / $1,049.00	Professional		$169.18	$247.17	$1,049.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $73.43 / $116.45 / $855.01	Professional	26	$73.43	$116.45	$855.01
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $85.57 / $126.77 / $724.87	Professional	TC	$85.57	$126.77	$724.87
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $199.05 / $204.85 / $337.02	Facility	26	$199.05	$204.85	$337.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $237.15 / $290.31 / $351.36	Professional		$237.15	$290.31	$351.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $67.23 / $117.22 / $234.21	Professional		$67.23	$117.22	$234.21
United Facility/Professional Professional Modifier Low / Median / High Price $169.18 / $247.17 / $302.10	Professional		$169.18	$247.17	$302.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.43 / $115.51 / $149.30	Professional	26	$73.43	$115.51	$149.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.57 / $119.18 / $149.60	Professional	TC	$85.57	$119.18	$149.60