Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.09 / $113.52 / $142.03	Facility		$35.09	$113.52	$142.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.14 / $20.14 / $20.14	Facility	26	$20.14	$20.14	$20.14
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $14.94 / $312.07 / $331.36	Facility	TC	$14.94	$312.07	$331.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.31 / $75.25 / $173.17	Professional		$33.31	$75.25	$173.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.14 / $24.51 / $57.97	Professional	26	$20.14	$24.51	$57.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $234.74 / $234.74 / $234.74	Professional	50	$234.74	$234.74	$234.74
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.55 / $26.35 / $120.52	Professional	52	$17.55	$26.35	$120.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.94 / $49.70 / $95.08	Professional	TC	$14.94	$49.70	$95.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.22 / $46.22 / $46.22	Professional	26	$46.22	$46.22	$46.22
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 $33.63 / $56.75 / $79.50	Professional		$33.63	$56.75	$79.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.98 / $32.02 / $43.14	Professional	26	$18.98	$32.02	$43.14
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.64 / $24.71 / $34.63	Professional	TC	$14.64	$24.71	$34.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.14 / $87.09 / $97.87	Professional		$59.14	$87.09	$97.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.03 / $42.57 / $55.06	Professional	26	$25.03	$42.57	$55.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.54 / $37.90 / $60.64	Professional	TC	$29.54	$37.90	$60.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.11 / $108.57 / $190.82	Facility		$38.11	$108.57	$190.82
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $141.03 / $141.03 / $141.03	Facility	TC	$141.03	$141.03	$141.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.15 / $87.23 / $402.37	Professional		$53.15	$87.23	$402.37
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.38 / $41.15 / $130.60	Professional	26	$26.38	$41.15	$130.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.77 / $42.65 / $284.52	Professional	TC	$26.77	$42.65	$284.52
Midlands Facility/Professional Facility Modifier Low / Median / High Price $70.08 / $91.66 / $134.00	Facility		$70.08	$91.66	$134.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $73.00 / $96.83 / $137.76	Professional		$73.00	$96.83	$137.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.32 / $32.27 / $60.66	Professional		$22.32	$32.27	$60.66
United Facility/Professional Professional Modifier Low / Median / High Price $53.15 / $87.23 / $124.96	Professional		$53.15	$87.23	$124.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.38 / $41.15 / $51.76	Professional	26	$26.38	$41.15	$51.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.77 / $38.56 / $84.24	Professional	TC	$26.77	$38.56	$84.24