Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.92 / $95.00 / $436.86	Professional		$61.92	$95.00	$436.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.84 / $71.94 / $99.27	Professional	26	$21.84	$71.94	$99.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.08 / $40.08 / $142.41	Professional	TC	$40.08	$40.08	$142.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.77 / $50.72 / $209.98	Professional		$49.77	$50.72	$209.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.82 / $52.21 / $71.40	Professional	26	$15.82	$52.21	$71.40
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 $108.45 / $153.61 / $161.69	Professional		$108.45	$153.61	$161.69
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.82 / $50.72 / $53.39	Professional	26	$35.82	$50.72	$53.39
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.62 / $102.88 / $108.29	Professional	TC	$72.62	$102.88	$108.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.87 / $196.22 / $248.29	Professional		$167.87	$196.22	$248.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.81 / $65.98 / $77.45	Professional	26	$58.81	$65.98	$77.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.00 / $133.82 / $166.30	Professional	TC	$95.00	$133.82	$166.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.92 / $193.17 / $510.17	Facility		$61.92	$193.17	$510.17
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $170.73 / $170.73 / $170.73	Facility	26	$170.73	$170.73	$170.73
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $357.27 / $357.27 / $357.27	Facility	TC	$357.27	$357.27	$357.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.52 / $180.34 / $661.34	Professional		$89.52	$180.34	$661.34
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.53 / $62.21 / $82.86	Professional	26	$35.53	$62.21	$82.86
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $50.25 / $63.74 / $424.71	Professional	TC	$50.25	$63.74	$424.71
Midlands Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $196.22 / $280.95	Facility		$165.00	$196.22	$280.95
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $109.73 / $109.73 / $109.73	Facility	26	$109.73	$109.73	$109.73
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $171.23 / $171.23 / $171.23	Facility	TC	$171.23	$171.23	$171.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $151.00 / $196.22 / $248.29	Professional		$151.00	$196.22	$248.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.18 / $118.66 / $206.94	Professional		$37.18	$118.66	$206.94
United Facility/Professional Professional Modifier Low / Median / High Price $81.58 / $99.27 / $198.54	Professional		$81.58	$99.27	$198.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.53 / $35.53 / $82.47	Professional	26	$29.53	$35.53	$82.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.25 / $63.74 / $126.68	Professional	TC	$50.25	$63.74	$126.68