Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $323.59 / $724.44	Facility		$144.54	$323.59	$724.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $45.71 / $64.57	Facility	26	$27.54	$45.71	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $177.83 / $660.69	Professional		$112.20	$177.83	$660.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $26.92 / $52.48	Professional	26	$19.05	$26.92	$52.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $141.25 / $257.04	Professional	TC	$97.72	$141.25	$257.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $102.33 / $141.25	Professional		$81.28	$102.33	$141.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $34.67 / $45.71	Professional	26	$21.38	$34.67	$45.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $85.11 / $85.11	Professional	TC	$85.11	$85.11	$85.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $630.96 / $1,288.25	Facility		$501.19	$630.96	$1,288.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $190.55 / $263.03	Professional		$114.82	$190.55	$263.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $31.62 / $43.65	Professional	26	$19.05	$31.62	$43.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $158.49 / $218.78	Professional	TC	$95.50	$158.49	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $275.42 / $354.81	Professional		$117.49	$275.42	$354.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $42.66 / $58.88	Professional	26	$20.42	$42.66	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $239.88 / $295.12	Professional	TC	$97.72	$239.88	$295.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $204.17 / $616.60	Facility		$117.49	$204.17	$616.60
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $177.83 / $177.83	Facility	26	$177.83	$177.83	$177.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $245.47 / $1,174.90	Professional		$138.04	$245.47	$1,174.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $40.74 / $309.03	Professional	26	$22.91	$40.74	$309.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $223.87 / $1,047.13	Professional	TC	$141.25	$223.87	$1,047.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $275.42 / $331.13	Professional		$251.19	$275.42	$331.13
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $46.77 / $56.23	Professional	26	$41.69	$46.77	$56.23
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $229.09 / $275.42	Professional	TC	$208.93	$229.09	$275.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $288.40 / $302.00	Professional		$186.21	$288.40	$302.00
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $37.15 / $46.77	Professional	26	$26.92	$37.15	$46.77
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $239.88 / $263.03	Professional	TC	$158.49	$239.88	$263.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $128.82 / $269.15	Professional		$23.99	$128.82	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $144.54 / $323.59	Facility		$25.70	$144.54	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $234.42 / $331.13	Professional		$134.90	$234.42	$331.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $38.02 / $52.48	Professional	26	$22.91	$38.02	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $199.53 / $288.40	Professional	TC	$112.20	$199.53	$288.40