Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.66 / $740.25 / $1,090.97	Facility		$118.66	$740.25	$1,090.97
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.33 / $49.72 / $74.04	Facility	26	$21.33	$49.72	$74.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.82 / $171.03 / $593.00	Professional		$113.82	$171.03	$593.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.44 / $31.25 / $117.00	Professional	26	$18.44	$31.25	$117.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.53 / $102.26 / $240.00	Professional	TC	$95.53	$102.26	$240.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.82 / $234.82 / $234.82	Professional		$234.82	$234.82	$234.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.14 / $37.78 / $49.76	Professional	26	$17.14	$37.78	$49.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $252.82 / $342.64 / $643.22	Facility		$252.82	$342.64	$643.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.92 / $193.56 / $261.18	Professional		$114.92	$193.56	$261.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.53 / $34.64 / $46.68	Professional	26	$20.53	$34.64	$46.68
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $94.39 / $158.77 / $214.52	Professional	TC	$94.39	$158.77	$214.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.00 / $263.00 / $263.00	Facility		$263.00	$263.00	$263.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.29 / $280.98 / $374.25	Professional		$147.29	$280.98	$374.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.00 / $48.99 / $61.49	Professional	26	$24.00	$48.99	$61.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.94 / $242.48 / $318.42	Professional	TC	$128.94	$242.48	$318.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $118.66 / $213.59 / $599.46	Facility		$118.66	$213.59	$599.46
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $161.00 / $161.00 / $161.00	Facility	26	$161.00	$161.00	$161.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $215.00 / $280.44 / $1,223.39	Professional		$215.00	$280.44	$1,223.39
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $31.60 / $45.12 / $237.75	Professional	26	$31.60	$45.12	$237.75
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $185.60 / $257.52 / $1,114.63	Professional	TC	$185.60	$257.52	$1,114.63
Midlands Facility/Professional Facility Modifier Low / Median / High Price $235.00 / $280.98 / $362.70	Facility		$235.00	$280.98	$362.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $196.49 / $254.78 / $346.97	Professional		$196.49	$254.78	$346.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.66 / $202.30 / $290.20	Professional		$41.66	$202.30	$290.20
United Facility/Professional Professional Modifier Low / Median / High Price $212.88 / $308.89 / $342.04	Professional		$212.88	$308.89	$342.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.60 / $46.28 / $56.76	Professional	26	$31.60	$46.28	$56.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.48 / $258.30 / $291.92	Professional	TC	$177.48	$258.30	$291.92