Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $173.78 / $251.19	Facility	26	$109.65	$173.78	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $380.19 / $1,148.15	Professional		$218.78	$380.19	$1,148.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $131.83 / $398.11	Professional	26	$77.62	$131.83	$398.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $173.78 / $363.08	Professional	TC	$138.04	$173.78	$363.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $204.17 / $549.54	Professional		$186.21	$204.17	$549.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $97.72 / $154.88	Professional	26	$81.28	$97.72	$154.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $346.74 / $478.63	Professional		$208.93	$346.74	$478.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $125.89 / $169.82	Professional	26	$75.86	$125.89	$169.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $223.87 / $309.03	Professional	TC	$138.04	$223.87	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $501.19 / $630.96	Professional		$213.80	$501.19	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $173.78 / $229.09	Professional	26	$79.43	$173.78	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $316.23 / $407.38	Professional	TC	$141.25	$316.23	$407.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $363.08 / $363.08 / $363.08	Facility	26	$363.08	$363.08	$363.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $426.58 / $2,398.83	Professional		$263.03	$426.58	$2,398.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $158.49 / $524.81	Professional	26	$102.33	$158.49	$524.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $269.15 / $977.24	Professional	TC	$177.83	$269.15	$977.24
Midlands Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $501.19 / $588.84	Professional		$446.68	$501.19	$588.84
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $177.83 / $223.87	Professional	26	$162.18	$177.83	$223.87
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $323.59 / $363.08	Professional	TC	$275.42	$323.59	$363.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $501.19 / $537.03	Professional		$354.81	$501.19	$537.03
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $177.83 / $194.98	Professional	26	$131.83	$177.83	$194.98
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $323.59 / $346.74	Professional	TC	$218.78	$323.59	$346.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $467.74 / $630.96	Professional		$416.87	$467.74	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $398.11 / $562.34	Professional		$263.03	$398.11	$562.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $154.88 / $208.93	Professional	26	$93.33	$154.88	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $239.88 / $346.74	Professional	TC	$151.36	$239.88	$346.74