Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.37 / $334.01 / $984.98	Professional		$67.37	$334.01	$984.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.37 / $87.82 / $320.89	Professional	26	$23.37	$87.82	$320.89
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.23 / $22.23 / $22.23	Professional	52	$22.23	$22.23	$22.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.09 / $59.51 / $147.30	Professional	TC	$21.09	$59.51	$147.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.53 / $60.50 / $135.36	Professional		$32.53	$60.50	$135.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.92 / $64.98 / $82.48	Professional	26	$16.92	$64.98	$82.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $65.29 / $65.29 / $65.29	Professional	TC	$65.29	$65.29	$65.29
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 $74.01 / $104.84 / $110.36	Professional		$74.01	$104.84	$110.36
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.31 / $54.25 / $57.11	Professional	26	$38.31	$54.25	$57.11
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.71 / $50.57 / $53.22	Professional	TC	$35.71	$50.57	$53.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.17 / $136.35 / $169.45	Professional		$119.17	$136.35	$169.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.87 / $70.59 / $87.00	Professional	26	$62.87	$70.59	$87.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.71 / $65.78 / $81.73	Professional	TC	$50.71	$65.78	$81.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.46 / $144.47 / $369.57	Facility		$44.46	$144.47	$369.57
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $163.47 / $163.47 / $163.47	Facility	26	$163.47	$163.47	$163.47
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $216.27 / $216.27 / $216.27	Facility	TC	$216.27	$216.27	$216.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.95 / $129.76 / $168.78	Professional		$66.95	$129.76	$168.78
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.14 / $68.40 / $88.71	Professional	26	$51.14	$68.40	$88.71
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.97 / $32.11 / $349.50	Professional	TC	$28.97	$32.11	$349.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $119.17 / $136.35 / $283.07	Facility		$119.17	$136.35	$283.07
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $139.31 / $139.31 / $139.31	Facility	26	$139.31	$139.31	$139.31
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $143.77 / $143.77 / $143.77	Facility	TC	$143.77	$143.77	$143.77
Midlands Facility/Professional Professional Modifier Low / Median / High Price $105.51 / $131.46 / $169.45	Professional		$105.51	$131.46	$169.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.65 / $64.34 / $133.40	Professional		$37.65	$64.34	$133.40
United Facility/Professional Professional Modifier Low / Median / High Price $63.61 / $66.98 / $176.78	Professional		$63.61	$66.98	$176.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.64 / $37.99 / $75.81	Professional	26	$33.64	$37.99	$75.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.96 / $30.36 / $83.84	Professional	TC	$28.96	$30.36	$83.84