Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $224.39 / $808.01 / $1,439.90	Facility		$224.39	$808.01	$1,439.90
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.08 / $81.52 / $119.22	Facility	26	$35.08	$81.52	$119.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $187.86 / $395.42 / $747.38	Facility	TC	$187.86	$395.42	$747.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.49 / $406.07 / $951.00	Professional		$178.49	$406.07	$951.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $51.34 / $172.00	Professional	26	$26.96	$51.34	$172.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.63 / $187.86 / $271.83	Professional	TC	$151.63	$187.86	$271.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $185.04 / $185.04 / $185.04	Professional		$185.04	$185.04	$185.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.13 / $48.36 / $72.50	Professional	26	$28.13	$48.36	$72.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $370.81 / $502.54 / $943.40	Facility		$370.81	$502.54	$943.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.97 / $360.99 / $486.31	Professional		$213.97	$360.99	$486.31
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.70 / $56.85 / $76.59	Professional	26	$33.70	$56.85	$76.59
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $180.25 / $304.12 / $409.69	Professional	TC	$180.25	$304.12	$409.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $534.00 / $534.00 / $534.00	Facility		$534.00	$534.00	$534.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $250.35 / $499.70 / $632.01	Professional		$250.35	$499.70	$632.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.18 / $80.70 / $100.36	Professional	26	$38.18	$80.70	$100.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.38 / $425.02 / $531.64	Professional	TC	$221.38	$425.02	$531.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $222.94 / $395.36 / $1,071.77	Facility		$222.94	$395.36	$1,071.77
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $205.00 / $205.00 / $205.00	Facility	26	$205.00	$205.00	$205.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $906.68 / $906.68 / $906.68	Facility	TC	$906.68	$906.68	$906.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $360.76 / $471.58 / $1,952.19	Professional		$360.76	$471.58	$1,952.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $47.08 / $73.45 / $399.57	Professional	26	$47.08	$73.45	$399.57
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $316.99 / $407.98 / $1,791.16	Professional	TC	$316.99	$407.98	$1,791.16
Midlands Facility/Professional Facility Modifier Low / Median / High Price $376.96 / $478.59 / $632.01	Facility		$376.96	$478.59	$632.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $322.00 / $457.96 / $632.01	Professional		$322.00	$457.96	$632.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.52 / $360.22 / $552.70	Professional		$68.52	$360.22	$552.70
United Facility/Professional Professional Modifier Low / Median / High Price $360.76 / $489.72 / $578.39	Professional		$360.76	$489.72	$578.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.08 / $73.45 / $92.40	Professional	26	$47.08	$73.45	$92.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $316.99 / $406.84 / $492.94	Professional	TC	$316.99	$406.84	$492.94