Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.47 / $151.10 / $571.52	Facility		$44.47	$151.10	$571.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.91 / $28.91 / $28.91	Facility	26	$28.91	$28.91	$28.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.99 / $83.92 / $195.00	Professional		$40.99	$83.92	$195.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.33 / $35.97 / $74.92	Professional	26	$28.33	$35.97	$74.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $72.88 / $326.11 / $334.86	Professional	50	$72.88	$326.11	$334.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.24 / $22.24 / $167.43	Professional	52	$22.24	$22.24	$167.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.56 / $52.74 / $127.15	Professional	TC	$15.56	$52.74	$127.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.73 / $99.94 / $187.61	Facility		$73.73	$99.94	$187.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.89 / $72.40 / $101.43	Professional		$42.89	$72.40	$101.43
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.66 / $46.67 / $62.86	Professional	26	$27.66	$46.67	$62.86
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.24 / $25.71 / $36.02	Professional	TC	$15.24	$25.71	$36.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.93 / $111.10 / $131.54	Professional		$62.93	$111.10	$131.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.32 / $63.41 / $81.54	Professional	26	$29.32	$63.41	$81.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.74 / $41.76 / $74.81	Professional	TC	$31.74	$41.76	$74.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.47 / $88.94 / $215.17	Facility		$44.47	$88.94	$215.17
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $134.74 / $134.74 / $134.74	Facility	26	$134.74	$134.74	$134.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $73.81 / $110.55 / $459.15	Professional		$73.81	$110.55	$459.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.01 / $51.62 / $188.73	Professional	26	$38.01	$51.62	$188.73
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $35.79 / $55.85 / $313.58	Professional	TC	$35.79	$55.85	$313.58
Midlands Facility/Professional Facility Modifier Low / Median / High Price $89.40 / $124.13 / $141.96	Facility		$89.40	$124.13	$141.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $92.00 / $132.22 / $175.41	Professional		$92.00	$132.22	$175.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.44 / $56.41 / $172.60	Professional		$25.44	$56.41	$172.60
United Facility/Professional Professional Modifier Low / Median / High Price $73.81 / $110.55 / $144.85	Professional		$73.81	$110.55	$144.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.01 / $48.66 / $74.59	Professional	26	$38.01	$48.66	$74.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.79 / $55.85 / $90.52	Professional	TC	$35.79	$55.85	$90.52