Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.51 / $560.00 / $840.00	Professional		$103.51	$560.00	$840.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.02 / $24.02 / $250.29	Professional	26	$24.02	$24.02	$250.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.48 / $79.48 / $272.35	Professional	TC	$79.48	$79.48	$272.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.83 / $75.83 / $294.00	Professional		$75.83	$75.83	$294.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.48 / $17.48 / $85.50	Professional	26	$17.48	$17.48	$85.50
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 $176.15 / $249.50 / $262.63	Professional		$176.15	$249.50	$262.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.39 / $55.78 / $58.72	Professional	26	$39.39	$55.78	$58.72
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $136.77 / $193.72 / $203.91	Professional	TC	$136.77	$193.72	$203.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $231.00 / $301.01 / $385.75	Professional		$231.00	$301.01	$385.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.00 / $71.14 / $85.93	Professional	26	$57.00	$71.14	$85.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $174.00 / $235.80 / $299.83	Professional	TC	$174.00	$235.80	$299.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $103.51 / $289.16 / $782.64	Facility		$103.51	$289.16	$782.64
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $213.67 / $213.67 / $213.67	Facility	26	$213.67	$213.67	$213.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $107.55 / $161.51 / $1,081.50	Professional		$107.55	$161.51	$1,081.50
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $36.39 / $40.06 / $235.79	Professional	26	$36.39	$40.06	$235.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $69.58 / $122.80 / $845.71	Professional	TC	$69.58	$122.80	$845.71
Midlands Facility/Professional Facility Modifier Low / Median / High Price $281.82 / $301.01 / $403.28	Facility		$281.82	$301.01	$403.28
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $97.66 / $97.66 / $97.66	Facility	26	$97.66	$97.66	$97.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $235.04 / $301.01 / $403.28	Professional		$235.04	$301.01	$403.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.06 / $181.37 / $316.24	Professional		$41.06	$181.37	$316.24
United Facility/Professional Professional Modifier Low / Median / High Price $107.55 / $161.51 / $313.05	Professional		$107.55	$161.51	$313.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.57 / $38.71 / $77.42	Professional	26	$34.57	$38.71	$77.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.68 / $122.80 / $201.09	Professional	TC	$73.68	$122.80	$201.09