Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.23 / $73.23 / $73.23	Professional		$73.23	$73.23	$73.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.22 / $38.14 / $168.21	Professional	26	$26.22	$38.14	$168.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.03 / $47.03 / $47.03	Professional	TC	$47.03	$47.03	$47.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.78 / $62.17 / $91.81	Professional	26	$18.78	$62.17	$91.81
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 $123.34 / $174.69 / $183.88	Professional		$123.34	$174.69	$183.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.64 / $60.39 / $63.57	Professional	26	$42.64	$60.39	$63.57
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.70 / $114.29 / $120.31	Professional	TC	$80.70	$114.29	$120.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.00 / $220.36 / $268.49	Professional		$201.00	$220.36	$268.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.88 / $78.56 / $97.00	Professional	26	$69.88	$78.56	$97.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.00 / $142.12 / $177.46	Professional	TC	$106.00	$142.12	$177.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.23 / $254.40 / $540.45	Facility		$73.23	$254.40	$540.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $221.64 / $221.64 / $221.64	Facility	26	$221.64	$221.64	$221.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $108.11 / $127.40 / $764.45	Professional		$108.11	$127.40	$764.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $42.59 / $72.44 / $310.87	Professional	26	$42.59	$72.44	$310.87
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $57.31 / $75.55 / $507.20	Professional	TC	$57.31	$75.55	$507.20
Midlands Facility/Professional Facility Modifier Low / Median / High Price $201.00 / $220.36 / $321.12	Facility		$201.00	$220.36	$321.12
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $137.11 / $137.11 / $137.11	Facility	26	$137.11	$137.11	$137.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $165.21 / $220.36 / $276.32	Professional		$165.21	$220.36	$276.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $44.48 / $119.17 / $219.87	Professional		$44.48	$119.17	$219.87
United Facility/Professional Professional Modifier Low / Median / High Price $105.42 / $118.14 / $229.32	Professional		$105.42	$118.14	$229.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.72 / $42.61 / $106.68	Professional	26	$37.72	$42.61	$106.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.31 / $75.55 / $150.07	Professional	TC	$57.31	$75.55	$150.07