Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.17 / $69.17 / $213.15	Professional		$69.17	$69.17	$213.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.63 / $61.84 / $120.60	Professional	26	$16.63	$61.84	$120.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.54 / $52.54 / $52.54	Professional	TC	$52.54	$52.54	$52.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.19 / $50.11 / $160.35	Professional		$49.19	$50.11	$160.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.36 / $39.75 / $58.70	Professional	26	$12.36	$39.75	$58.70
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 $114.69 / $162.44 / $170.99	Professional		$114.69	$162.44	$170.99
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.27 / $38.63 / $40.65	Professional	26	$27.27	$38.63	$40.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.42 / $123.81 / $130.33	Professional	TC	$87.42	$123.81	$130.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $195.05 / $251.05	Professional		$160.00	$195.05	$251.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.84 / $49.14 / $58.95	Professional	26	$44.84	$49.14	$58.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.00 / $150.21 / $193.41	Professional	TC	$113.00	$150.21	$193.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.77 / $190.23 / $507.12	Facility		$41.77	$190.23	$507.12
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $116.58 / $116.58 / $116.58	Facility	26	$116.58	$116.58	$116.58
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $390.55 / $390.55 / $390.55	Facility	TC	$390.55	$390.55	$390.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $129.00 / $715.47	Professional		$87.10	$129.00	$715.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.61 / $46.81 / $76.90	Professional	26	$26.61	$46.81	$76.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $60.49 / $79.59 / $552.78	Professional	TC	$60.49	$79.59	$552.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $156.00 / $195.05 / $262.55	Facility		$156.00	$195.05	$262.55
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $69.80 / $69.80 / $69.80	Facility	26	$69.80	$69.80	$69.80
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $180.75 / $180.75 / $180.75	Facility	TC	$180.75	$180.75	$180.75
Midlands Facility/Professional Professional Modifier Low / Median / High Price $143.00 / $187.94 / $258.42	Professional		$143.00	$187.94	$258.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.43 / $117.26 / $204.45	Professional		$28.43	$117.26	$204.45
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $98.75 / $197.50	Professional		$87.10	$98.75	$197.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.94 / $26.81 / $53.62	Professional	26	$23.94	$26.81	$53.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.49 / $71.94 / $142.91	Professional	TC	$60.49	$71.94	$142.91