Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.37 / $178.37 / $1,290.00	Professional		$178.37	$178.37	$1,290.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.32 / $77.91 / $240.54	Professional	26	$51.32	$77.91	$240.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $127.05 / $127.05 / $127.05	Professional	TC	$127.05	$127.05	$127.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $126.65 / $128.99 / $534.00	Professional		$126.65	$128.99	$534.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.97 / $118.35 / $180.24	Professional	26	$36.97	$118.35	$180.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $228.29 / $228.29 / $228.29	Facility		$228.29	$228.29	$228.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $293.37 / $415.51 / $437.38	Professional		$293.37	$415.51	$437.38
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.73 / $118.59 / $124.84	Professional	26	$83.73	$118.59	$124.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $209.63 / $296.89 / $312.52	Professional	TC	$209.63	$296.89	$312.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $421.00 / $500.72 / $641.20	Professional		$421.00	$500.72	$641.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $137.99 / $152.83 / $181.20	Professional	26	$137.99	$152.83	$181.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $279.00 / $362.74 / $460.00	Professional	TC	$279.00	$362.74	$460.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $133.88 / $386.98 / $1,301.88	Facility		$133.88	$386.98	$1,301.88
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $358.77 / $358.77 / $358.77	Facility	26	$358.77	$358.77	$358.77
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $943.11 / $943.11 / $943.11	Facility	TC	$943.11	$943.11	$943.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $206.35 / $381.82 / $1,813.36	Professional		$206.35	$381.82	$1,813.36
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $83.27 / $148.72 / $192.90	Professional	26	$83.27	$148.72	$192.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $113.20 / $192.49 / $1,303.99	Professional	TC	$113.20	$192.49	$1,303.99
Midlands Facility/Professional Facility Modifier Low / Median / High Price $345.00 / $500.72 / $637.07	Facility		$345.00	$500.72	$637.07
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $324.00 / $324.00 / $324.00	Facility	26	$324.00	$324.00	$324.00
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $303.68 / $303.68 / $303.68	Facility	TC	$303.68	$303.68	$303.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $311.61 / $500.72 / $641.20	Professional		$311.61	$500.72	$641.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $86.63 / $301.82 / $526.26	Professional		$86.63	$301.82	$526.26
United Facility/Professional Professional Modifier Low / Median / High Price $155.84 / $259.74 / $506.70	Professional		$155.84	$259.74	$506.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.87 / $83.27 / $159.35	Professional	26	$73.87	$83.27	$159.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $113.20 / $176.47 / $350.78	Professional	TC	$113.20	$176.47	$350.78