Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.72 / $194.77 / $261.02	Facility	26	$78.72	$194.77	$261.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $217.38 / $281.74 / $1,141.00	Professional		$217.38	$281.74	$1,141.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.72 / $97.13 / $329.62	Professional	26	$78.72	$97.13	$329.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.66 / $165.09 / $400.00	Professional	TC	$138.66	$165.09	$400.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $428.47 / $428.47 / $428.47	Professional		$428.47	$428.47	$428.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $156.26 / $156.26 / $162.24	Professional	26	$156.26	$156.26	$162.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $209.31 / $353.12 / $475.69	Professional		$209.31	$353.12	$475.69
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.34 / $127.11 / $171.22	Professional	26	$75.34	$127.11	$171.22
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $133.97 / $226.00 / $304.47	Professional	TC	$133.97	$226.00	$304.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.20 / $501.06 / $606.29	Professional		$242.20	$501.06	$606.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.89 / $175.82 / $222.24	Professional	26	$90.89	$175.82	$222.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $189.41 / $316.85 / $396.06	Professional	TC	$189.41	$316.85	$396.06
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $366.35 / $366.35 / $366.35	Facility	26	$366.35	$366.35	$366.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $287.55 / $442.38 / $749.61	Professional		$287.55	$442.38	$749.61
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $108.90 / $167.54 / $240.16	Professional	26	$108.90	$167.54	$240.16
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $178.65 / $274.83 / $509.45	Professional	TC	$178.65	$274.83	$509.45
Midlands Facility/Professional Professional Modifier Low / Median / High Price $362.08 / $502.91 / $602.88	Professional		$362.08	$502.91	$602.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $153.85 / $295.88 / $495.30	Professional		$153.85	$295.88	$495.30
United Facility/Professional Professional Modifier Low / Median / High Price $299.08 / $497.68 / $570.41	Professional		$299.08	$497.68	$570.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.90 / $180.54 / $207.50	Professional	26	$108.90	$180.54	$207.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $178.65 / $282.70 / $363.84	Professional	TC	$178.65	$282.70	$363.84