Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $454.79 / $1,837.84 / $2,833.16	Facility		$454.79	$1,837.84	$2,833.16
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.62 / $133.07 / $327.57	Facility	26	$65.62	$133.07	$327.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.19 / $263.27 / $867.00	Professional		$182.19	$263.27	$867.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.62 / $71.51 / $258.00	Professional	26	$63.62	$71.51	$258.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $118.24 / $175.12 / $350.00	Professional	TC	$118.24	$175.12	$350.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $426.09 / $426.09 / $426.09	Professional		$426.09	$426.09	$426.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $130.49 / $130.49 / $153.60	Professional	26	$130.49	$130.49	$153.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,216.35 / $1,648.48 / $3,094.62	Facility		$1,216.35	$1,648.48	$3,094.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.16 / $298.88 / $402.63	Professional		$177.16	$298.88	$402.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.89 / $103.97 / $142.91	Professional	26	$62.89	$103.97	$142.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.28 / $192.78 / $259.72	Professional	TC	$114.28	$192.78	$259.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,120.00 / $1,120.00 / $1,120.00	Facility		$1,120.00	$1,120.00	$1,120.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $215.21 / $408.97 / $517.05	Professional		$215.21	$408.97	$517.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.27 / $142.44 / $191.07	Professional	26	$77.27	$142.44	$191.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $160.06 / $269.39 / $336.74	Professional	TC	$160.06	$269.39	$336.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $312.56 / $1,879.56 / $2,726.00	Facility		$312.56	$1,879.56	$2,726.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $256.02 / $305.79 / $305.79	Facility	26	$256.02	$305.79	$305.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $254.24 / $399.04 / $610.02	Professional		$254.24	$399.04	$610.02
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $93.63 / $140.44 / $179.15	Professional	26	$93.63	$140.44	$179.15
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $160.61 / $277.98 / $430.87	Professional	TC	$160.61	$277.98	$430.87
Midlands Facility/Professional Facility Modifier Low / Median / High Price $369.19 / $452.51 / $543.11	Facility		$369.19	$452.51	$543.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $331.29 / $426.54 / $542.78	Professional		$331.29	$426.54	$542.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $128.60 / $251.59 / $413.50	Professional		$128.60	$251.59	$413.50
United Facility/Professional Professional Modifier Low / Median / High Price $254.24 / $438.51 / $492.93	Professional		$254.24	$438.51	$492.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.63 / $143.74 / $178.40	Professional	26	$93.63	$143.74	$178.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $160.61 / $282.00 / $323.82	Professional	TC	$160.61	$282.00	$323.82