Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.65 / $93.65 / $93.65	Professional		$93.65	$93.65	$93.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.53 / $22.53 / $88.91	Professional	26	$22.53	$22.53	$88.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.12 / $71.12 / $71.12	Professional	TC	$71.12	$71.12	$71.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.66 / $63.66 / $63.66	Professional		$63.66	$63.66	$63.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.00 / $75.00 / $79.53	Professional	26	$75.00	$75.00	$79.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.66 / $216.24 / $227.62	Professional		$152.66	$216.24	$227.62
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.95 / $52.34 / $55.09	Professional	26	$36.95	$52.34	$55.09
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $115.73 / $163.91 / $172.53	Professional	TC	$115.73	$163.91	$172.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.23 / $253.81 / $341.30	Professional		$190.23	$253.81	$341.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.55 / $68.06 / $79.84	Professional	26	$60.55	$68.06	$79.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.48 / $192.17 / $262.43	Professional	TC	$123.48	$192.17	$262.43
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $173.52 / $173.52 / $173.52	Facility	26	$173.52	$173.52	$173.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.88 / $128.47 / $973.09	Professional		$89.88	$128.47	$973.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $34.14 / $41.64 / $236.03	Professional	26	$34.14	$41.64	$236.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $49.93 / $107.76 / $750.23	Professional	TC	$49.93	$107.76	$750.23
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $109.95 / $109.95 / $109.95	Facility	26	$109.95	$109.95	$109.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $139.00 / $212.59 / $341.30	Professional		$139.00	$212.59	$341.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.19 / $149.41 / $260.51	Professional		$38.19	$149.41	$260.51
United Facility/Professional Professional Modifier Low / Median / High Price $89.88 / $118.76 / $231.26	Professional		$89.88	$118.76	$231.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.80 / $36.32 / $72.64	Professional	26	$21.80	$36.32	$72.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.93 / $82.44 / $164.88	Professional	TC	$49.93	$82.44	$164.88