Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.79 / $40.79 / $40.79	Professional		$40.79	$40.79	$40.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.98 / $31.79 / $104.50	Professional	26	$13.98	$31.79	$104.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.81 / $26.81 / $26.81	Professional	TC	$26.81	$26.81	$26.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.91 / $100.91 / $100.91	Professional		$100.91	$100.91	$100.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.13 / $33.43 / $49.37	Professional	26	$10.13	$33.43	$49.37
BCBS Facility/Professional Facility Modifier Low / Median / High Price $377.05 / $377.05 / $377.05	Facility		$377.05	$377.05	$377.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.06 / $99.23 / $104.45	Professional		$70.06	$99.23	$104.45
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.94 / $32.47 / $34.18	Professional	26	$22.94	$32.47	$34.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.11 / $66.75 / $70.26	Professional	TC	$47.11	$66.75	$70.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.67 / $123.00 / $156.65	Professional		$104.67	$123.00	$156.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.85 / $42.25 / $49.63	Professional	26	$37.85	$42.25	$49.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.35 / $84.42 / $107.03	Professional	TC	$63.35	$84.42	$107.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.79 / $125.32 / $317.91	Facility		$40.79	$125.32	$317.91
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $113.52 / $113.52 / $113.52	Facility	26	$113.52	$113.52	$113.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $72.48 / $407.64	Professional		$58.40	$72.48	$407.64
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.19 / $37.84 / $244.00	Professional	26	$21.19	$37.84	$244.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $35.86 / $40.61 / $268.50	Professional	TC	$35.86	$40.61	$268.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $104.67 / $124.00 / $188.10	Facility		$104.67	$124.00	$188.10
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $56.79 / $56.79 / $56.79	Facility	26	$56.79	$56.79	$56.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $92.00 / $114.04 / $156.65	Professional		$92.00	$114.04	$156.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.16 / $72.78 / $128.66	Professional		$24.16	$72.78	$128.66
United Facility/Professional Professional Modifier Low / Median / High Price $55.48 / $61.81 / $117.95	Professional		$55.48	$61.81	$117.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.13 / $22.54 / $54.92	Professional	26	$20.13	$22.54	$54.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.07 / $38.08 / $71.45	Professional	TC	$34.07	$38.08	$71.45