Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.06 / $65.59 / $269.77	Facility		$21.06	$65.59	$269.77
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.71 / $2.71 / $2.71	Facility	26	$2.71	$2.71	$2.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.06 / $34.83 / $44.97	Professional		$21.06	$34.83	$44.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.71 / $4.15 / $7.00	Professional	26	$2.71	$4.15	$7.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.53 / $10.53 / $58.96	Professional	52	$10.53	$10.53	$58.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.35 / $24.33 / $47.21	Professional	TC	$18.35	$24.33	$47.21
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 $20.52 / $34.35 / $46.63	Professional		$20.52	$34.35	$46.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $2.60 / $4.40 / $5.91	Professional	26	$2.60	$4.40	$5.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.91 / $29.60 / $40.71	Professional	TC	$17.91	$29.60	$40.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.97 / $47.88 / $58.32	Professional		$26.97	$47.88	$58.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.77 / $6.40 / $7.71	Professional	26	$3.77	$6.40	$7.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.20 / $41.87 / $49.95	Professional	TC	$23.20	$41.87	$49.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $21.59 / $42.12 / $95.94	Facility		$21.59	$42.12	$95.94
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 Professional Modifier Low / Median / High Price $25.06 / $49.18 / $311.26	Professional		$25.06	$49.18	$311.26
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $3.61 / $6.74 / $129.00	Professional	26	$3.61	$6.74	$129.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.45 / $40.39 / $252.63	Professional	TC	$21.45	$40.39	$252.63
Midlands Facility/Professional Facility Modifier Low / Median / High Price $40.01 / $47.88 / $78.00	Facility		$40.01	$47.88	$78.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $29.83 / $47.88 / $61.02	Professional		$29.83	$47.88	$61.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.27 / $21.49 / $40.50	Professional		$3.27	$21.49	$40.50
United Facility/Professional Professional Modifier Low / Median / High Price $25.06 / $44.51 / $56.68	Professional		$25.06	$44.51	$56.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.61 / $6.42 / $16.78	Professional	26	$3.61	$6.42	$16.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.45 / $39.99 / $45.62	Professional	TC	$21.45	$39.99	$45.62