Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.79 / $75.15 / $119.69	Facility	26	$35.79	$75.15	$119.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.06 / $216.82 / $918.85	Professional		$167.06	$216.82	$918.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.53 / $40.95 / $113.00	Professional	26	$31.53	$40.95	$113.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.44 / $169.96 / $357.19	Professional	TC	$141.44	$169.96	$357.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.04 / $147.04 / $407.06	Professional		$147.04	$147.04	$407.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.62 / $38.69 / $73.28	Professional	26	$28.62	$38.69	$73.28
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $323.77 / $323.77 / $323.77	Professional	TC	$323.77	$323.77	$323.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.34 / $285.70 / $384.88	Professional		$169.34	$285.70	$384.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.00 / $57.36 / $77.28	Professional	26	$34.00	$57.36	$77.28
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $135.34 / $228.34 / $307.61	Professional	TC	$135.34	$228.34	$307.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.56 / $396.41 / $497.73	Professional		$197.56	$396.41	$497.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.04 / $76.14 / $102.13	Professional	26	$36.04	$76.14	$102.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $164.67 / $320.33 / $400.42	Professional	TC	$164.67	$320.33	$400.42
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $210.00 / $210.00 / $210.00	Facility	26	$210.00	$210.00	$210.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $296.07 / $371.66 / $1,582.03	Professional		$296.07	$371.66	$1,582.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $49.40 / $72.83 / $422.69	Professional	26	$49.40	$72.83	$422.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $236.00 / $317.48 / $1,414.75	Professional	TC	$236.00	$317.48	$1,414.75
Midlands Facility/Professional Professional Modifier Low / Median / High Price $294.69 / $380.32 / $497.73	Professional		$294.69	$380.32	$497.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.25 / $195.46 / $356.35	Professional		$41.25	$195.46	$356.35
United Facility/Professional Professional Modifier Low / Median / High Price $297.33 / $364.60 / $455.84	Professional		$297.33	$364.60	$455.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.40 / $74.73 / $93.92	Professional	26	$49.40	$74.73	$93.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $225.68 / $317.48 / $371.16	Professional	TC	$225.68	$317.48	$371.16