Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.78 / $235.43 / $396.83	Facility	26	$43.78	$235.43	$396.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.22 / $998.22 / $1,343.79	Professional		$198.22	$998.22	$1,343.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.78 / $106.65 / $272.85	Professional	26	$43.78	$106.65	$272.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.44 / $154.44 / $1,070.94	Professional	TC	$154.44	$154.44	$1,070.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.96 / $56.96 / $60.31	Professional	26	$56.96	$56.96	$60.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $362.41 / $387.38 / $397.06	Professional		$362.41	$387.38	$397.06
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.65 / $86.20 / $88.34	Professional	26	$80.65	$86.20	$88.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $281.76 / $301.18 / $308.70	Professional	TC	$281.76	$301.18	$308.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $254.40 / $254.40 / $254.40	Facility	26	$254.40	$254.40	$254.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $397.21 / $485.59 / $606.99	Professional		$397.21	$485.59	$606.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.34 / $103.17 / $128.96	Professional	26	$87.34	$103.17	$128.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $308.83 / $382.42 / $478.03	Professional	TC	$308.83	$382.42	$478.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $210.21 / $210.21 / $210.21	Facility	26	$210.21	$210.21	$210.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $270.62 / $419.17 / $619.82	Professional		$270.62	$419.17	$619.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $58.15 / $91.69 / $133.84	Professional	26	$58.15	$91.69	$133.84
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $212.47 / $327.41 / $485.98	Professional	TC	$212.47	$327.41	$485.98
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $149.12 / $153.47 / $254.40	Facility	26	$149.12	$153.47	$254.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $392.47 / $469.73 / $610.16	Professional		$392.47	$469.73	$610.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.37 / $174.81 / $376.69	Professional		$50.37	$174.81	$376.69
United Facility/Professional Professional Modifier Low / Median / High Price $270.62 / $416.26 / $537.40	Professional		$270.62	$416.26	$537.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.15 / $90.61 / $117.55	Professional	26	$58.15	$90.61	$117.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $212.47 / $323.62 / $419.85	Professional	TC	$212.47	$323.62	$419.85