Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.76 / $63.76 / $63.76	Professional		$63.76	$63.76	$63.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.78 / $57.52 / $298.77	Professional	26	$38.78	$57.52	$298.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.97 / $24.97 / $24.97	Professional	TC	$24.97	$24.97	$24.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.49 / $147.49 / $147.49	Professional		$147.49	$147.49	$147.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.01 / $92.71 / $136.91	Professional	26	$28.01	$92.71	$136.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $136.36 / $136.36 / $136.36	Facility		$136.36	$136.36	$136.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.69 / $148.28 / $156.08	Professional		$104.69	$148.28	$156.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.27 / $89.60 / $94.32	Professional	26	$63.27	$89.60	$94.32
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.40 / $58.65 / $61.75	Professional	TC	$41.40	$58.65	$61.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.00 / $175.84 / $227.65	Professional		$159.00	$175.84	$227.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.00 / $115.35 / $137.68	Professional	26	$104.00	$115.35	$137.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.00 / $71.03 / $91.02	Professional	TC	$55.00	$71.03	$91.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.76 / $202.48 / $457.19	Facility		$63.76	$202.48	$457.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $272.47 / $272.47 / $272.47	Facility	26	$272.47	$272.47	$272.47
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $184.67 / $184.67 / $184.67	Facility	TC	$184.67	$184.67	$184.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.81 / $100.33 / $643.49	Professional		$81.81	$100.33	$643.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $58.76 / $104.39 / $383.71	Professional	26	$58.76	$104.39	$383.71
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.07 / $37.84 / $350.03	Professional	TC	$25.07	$37.84	$350.03
Midlands Facility/Professional Facility Modifier Low / Median / High Price $156.00 / $175.84 / $247.01	Facility		$156.00	$175.84	$247.01
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $157.63 / $157.63 / $157.63	Facility	26	$157.63	$157.63	$157.63
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $89.38 / $89.38 / $89.38	Facility	TC	$89.38	$89.38	$89.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.82 / $175.84 / $227.65	Professional		$134.82	$175.84	$227.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.35 / $95.11 / $187.99	Professional		$42.35	$95.11	$187.99
United Facility/Professional Professional Modifier Low / Median / High Price $81.81 / $94.47 / $188.84	Professional		$81.81	$94.47	$188.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.82 / $62.83 / $125.66	Professional	26	$55.82	$62.83	$125.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.07 / $32.58 / $63.18	Professional	TC	$25.07	$32.58	$63.18