Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.06 / $100.06 / $100.06	Professional		$100.06	$100.06	$100.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.87 / $164.02 / $504.40	Professional	26	$43.87	$164.02	$504.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.19 / $56.19 / $56.19	Professional	TC	$56.19	$56.19	$56.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.50 / $77.50 / $144.43	Professional		$77.50	$77.50	$144.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.53 / $101.20 / $154.11	Professional	26	$31.53	$101.20	$154.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $136.36 / $136.36 / $136.36	Facility		$136.36	$136.36	$136.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.66 / $243.12 / $255.91	Professional		$171.66	$243.12	$255.91
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.59 / $101.41 / $106.75	Professional	26	$71.59	$101.41	$106.75
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.06 / $141.71 / $149.16	Professional	TC	$100.06	$141.71	$149.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.00 / $299.27 / $384.25	Professional		$245.00	$299.27	$384.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.61 / $130.37 / $154.88	Professional	26	$117.61	$130.37	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.00 / $181.66 / $229.07	Professional	TC	$123.00	$181.66	$229.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.06 / $290.01 / $778.10	Facility		$100.06	$290.01	$778.10
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $305.79 / $305.79 / $305.79	Facility	26	$305.79	$305.79	$305.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $121.05 / $160.00 / $1,961.76	Professional		$121.05	$160.00	$1,961.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $66.47 / $120.79 / $434.05	Professional	26	$66.47	$120.79	$434.05
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $56.03 / $85.14 / $557.54	Professional	TC	$56.03	$85.14	$557.54
Midlands Facility/Professional Facility Modifier Low / Median / High Price $240.00 / $299.27 / $392.99	Facility		$240.00	$299.27	$392.99
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $181.03 / $181.03 / $181.03	Facility	26	$181.03	$181.03	$181.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $195.00 / $280.08 / $384.25	Professional		$195.00	$280.08	$384.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $74.37 / $155.97 / $316.20	Professional		$74.37	$155.97	$316.20
United Facility/Professional Professional Modifier Low / Median / High Price $121.05 / $146.46 / $283.23	Professional		$121.05	$146.46	$283.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.15 / $71.13 / $138.94	Professional	26	$63.15	$71.13	$138.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.03 / $75.33 / $150.07	Professional	TC	$56.03	$75.33	$150.07