Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $145.88	Professional		$50.00	$50.00	$145.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.47 / $27.49 / $102.00	Professional	26	$7.47	$27.49	$102.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.53 / $42.53 / $42.53	Professional	TC	$42.53	$42.53	$42.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $117.15 / $117.15	Professional		$36.61	$117.15	$117.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.41 / $17.32 / $26.39	Professional	26	$5.41	$17.32	$26.39
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 $83.89 / $118.81 / $125.06	Professional		$83.89	$118.81	$125.06
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.25 / $17.35 / $18.27	Professional	26	$12.25	$17.35	$18.27
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.62 / $101.45 / $106.80	Professional	TC	$71.62	$101.45	$106.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.00 / $143.22 / $182.48	Professional		$111.00	$143.22	$182.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.38 / $22.58 / $26.54	Professional	26	$20.38	$22.58	$26.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.00 / $122.85 / $155.97	Professional	TC	$85.00	$122.85	$155.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $125.69 / $372.39	Facility		$50.00	$125.69	$372.39
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 $319.41 / $319.41 / $319.41	Facility	TC	$319.41	$319.41	$319.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.12 / $77.23 / $514.55	Professional		$60.12	$77.23	$514.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $20.82 / $34.00	Professional	26	$11.32	$20.82	$34.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $48.48 / $64.44 / $439.92	Professional	TC	$48.48	$64.44	$439.92
Midlands Facility/Professional Facility Modifier Low / Median / High Price $113.00 / $143.22 / $192.05	Facility		$113.00	$143.22	$192.05
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $31.15 / $31.15 / $31.15	Facility	26	$31.15	$31.15	$31.15
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $144.09 / $144.09 / $144.09	Facility	TC	$144.09	$144.09	$144.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.00 / $132.99 / $182.48	Professional		$102.00	$132.99	$182.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.74 / $85.67 / $149.37	Professional		$12.74	$85.67	$149.37
United Facility/Professional Professional Modifier Low / Median / High Price $60.12 / $71.97 / $139.01	Professional		$60.12	$71.97	$139.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.75 / $12.04 / $23.92	Professional	26	$10.75	$12.04	$23.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.48 / $58.50 / $116.28	Professional	TC	$48.48	$58.50	$116.28