Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.07 / $83.47 / $204.09	Professional		$26.07	$83.47	$204.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.02 / $26.42 / $55.89	Professional	26	$7.02	$26.42	$55.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $57.99 / $74.86	Professional	TC	$19.05	$57.99	$74.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.80 / $18.97 / $78.98	Professional		$18.80	$18.97	$78.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.09 / $16.29 / $21.07	Professional	26	$5.09	$16.29	$21.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $57.92 / $57.92 / $57.92	Professional	TC	$57.92	$57.92	$57.92
BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.09 / $128.09 / $128.09	Facility		$128.09	$128.09	$128.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.53 / $61.65 / $64.90	Professional		$43.53	$61.65	$64.90
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.52 / $16.32 / $17.19	Professional	26	$11.52	$16.32	$17.19
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.00 / $45.32 / $47.71	Professional	TC	$32.00	$45.32	$47.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.33 / $80.20 / $99.66	Professional		$68.33	$80.20	$99.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.21 / $21.24 / $26.39	Professional	26	$19.21	$21.24	$26.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.31 / $58.96 / $73.27	Professional	TC	$48.31	$58.96	$73.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.07 / $84.24 / $208.80	Facility		$26.07	$84.24	$208.80
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $164.16 / $164.16 / $164.16	Facility	TC	$164.16	$164.16	$164.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.32 / $68.00 / $360.92	Professional		$38.32	$68.00	$360.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $20.32 / $26.66	Professional	26	$11.32	$20.32	$26.66
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.00 / $29.95 / $268.14	Professional	TC	$27.00	$29.95	$268.14
Midlands Facility/Professional Facility Modifier Low / Median / High Price $68.33 / $80.20 / $166.05	Facility		$68.33	$80.20	$166.05
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $56.10 / $56.10 / $56.10	Facility	26	$56.10	$56.10	$56.10
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $109.95 / $109.95 / $109.95	Facility	TC	$109.95	$109.95	$109.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.03 / $75.30 / $99.66	Professional		$61.03	$75.30	$99.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.91 / $44.58 / $77.72	Professional		$11.91	$44.58	$77.72
United Facility/Professional Professional Modifier Low / Median / High Price $36.40 / $39.50 / $100.09	Professional		$36.40	$39.50	$100.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $11.32 / $22.64	Professional	26	$10.11	$11.32	$22.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.65 / $27.42 / $78.23	Professional	TC	$25.65	$27.42	$78.23