Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.44 / $41.44 / $162.03	Professional		$41.44	$41.44	$162.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $17.28 / $67.55	Professional	26	$5.01	$17.28	$67.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.16 / $24.16 / $28.13	Professional	TC	$24.16	$24.16	$28.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.66 / $30.66 / $30.66	Professional		$30.66	$30.66	$30.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.52 / $51.81 / $60.99	Professional	26	$12.52	$51.81	$60.99
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 $69.75 / $98.79 / $103.98	Professional		$69.75	$98.79	$103.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.34 / $40.14 / $42.25	Professional	26	$28.34	$40.14	$42.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.40 / $58.65 / $61.75	Professional	TC	$41.40	$58.65	$61.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.86 / $128.47 / $159.66	Professional		$110.86	$128.47	$159.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.28 / $52.20 / $64.87	Professional	26	$47.28	$52.20	$64.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.58 / $76.28 / $90.73	Professional	TC	$63.58	$76.28	$90.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.44 / $150.35 / $379.47	Facility		$41.44	$150.35	$379.47
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $234.18 / $234.18 / $234.18	Facility	26	$234.18	$234.18	$234.18
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $186.22 / $186.22 / $186.22	Facility	TC	$186.22	$186.22	$186.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.60 / $93.31 / $641.00	Professional		$58.60	$93.31	$641.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $27.32 / $51.19 / $79.00	Professional	26	$27.32	$51.19	$79.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.28 / $39.34 / $312.17	Professional	TC	$31.28	$39.34	$312.17
Midlands Facility/Professional Facility Modifier Low / Median / High Price $110.86 / $128.47 / $274.43	Facility		$110.86	$128.47	$274.43
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $150.38 / $150.38 / $150.38	Facility	26	$150.38	$150.38	$150.38
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $124.05 / $124.05 / $124.05	Facility	TC	$124.05	$124.05	$124.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.95 / $118.19 / $159.66	Professional		$102.95	$118.19	$159.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $29.58 / $61.54 / $125.09	Professional		$29.58	$61.54	$125.09
United Facility/Professional Professional Modifier Low / Median / High Price $58.60 / $63.71 / $169.35	Professional		$58.60	$63.71	$169.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.87 / $27.86 / $78.95	Professional	26	$24.87	$27.86	$78.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.04 / $35.85 / $71.70	Professional	TC	$34.04	$35.85	$71.70