Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.72 / $71.72 / $71.72	Professional		$71.72	$71.72	$71.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.16 / $22.07 / $274.58	Professional	26	$18.16	$22.07	$274.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.56 / $53.56 / $53.56	Professional	TC	$53.56	$53.56	$53.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.71 / $48.71 / $48.71	Professional		$48.71	$48.71	$48.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.08 / $64.08 / $64.08	Professional	26	$64.08	$64.08	$64.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.18 / $164.56 / $173.22	Professional		$116.18	$164.56	$173.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.78 / $42.17 / $44.39	Professional	26	$29.78	$42.17	$44.39
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $86.40 / $122.38 / $129.03	Professional	TC	$86.40	$122.38	$129.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.19 / $195.64 / $263.17	Professional		$134.19	$195.64	$263.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.00 / $53.03 / $64.38	Professional	26	$43.00	$53.03	$64.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.17 / $145.97 / $199.46	Professional	TC	$81.17	$145.97	$199.46
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $127.16 / $127.16 / $127.16	Facility	26	$127.16	$127.16	$127.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.83 / $94.19 / $750.04	Professional		$66.83	$94.19	$750.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $27.51 / $29.30 / $179.95	Professional	26	$27.51	$29.30	$179.95
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $39.15 / $63.87 / $570.15	Professional	TC	$39.15	$63.87	$570.15
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $110.00 / $110.00 / $110.00	Facility	26	$110.00	$110.00	$110.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $115.05 / $192.73 / $263.17	Professional		$115.05	$192.73	$263.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.11 / $116.26 / $202.71	Professional		$31.11	$116.26	$202.71
United Facility/Professional Professional Modifier Low / Median / High Price $52.26 / $87.10 / $140.34	Professional		$52.26	$87.10	$140.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.14 / $29.27 / $58.54	Professional	26	$26.14	$29.27	$58.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.15 / $57.83 / $114.42	Professional	TC	$39.15	$57.83	$114.42