Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.64 / $55.55 / $74.94	Facility	26	$21.64	$55.55	$74.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.93 / $128.43 / $562.00	Professional		$109.93	$128.43	$562.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.40 / $21.64 / $116.25	Professional	26	$14.40	$21.64	$116.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.00 / $102.26 / $155.07	Professional	TC	$93.00	$102.26	$155.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.33 / $38.33 / $38.33	Professional	26	$38.33	$38.33	$38.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.08 / $183.84 / $250.16	Professional		$110.08	$183.84	$250.16
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.82 / $35.14 / $47.34	Professional	26	$20.82	$35.14	$47.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.25 / $148.88 / $202.83	Professional	TC	$89.25	$148.88	$202.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.80 / $257.52 / $321.91	Professional		$125.80	$257.52	$321.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.27 / $46.50 / $62.36	Professional	26	$22.27	$46.50	$62.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $105.80 / $219.01 / $265.20	Professional	TC	$105.80	$219.01	$265.20
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $102.96 / $102.96 / $102.96	Facility	26	$102.96	$102.96	$102.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $188.91 / $238.92 / $1,021.59	Professional		$188.91	$238.92	$1,021.59
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $42.54 / $203.09	Professional	26	$25.26	$42.54	$203.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $153.58 / $213.69 / $934.78	Professional	TC	$153.58	$213.69	$934.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $187.07 / $243.19 / $316.73	Professional		$187.07	$243.19	$316.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $205.40 / $309.10 / $355.50	Professional		$205.40	$309.10	$355.50
United Facility/Professional Professional Modifier Low / Median / High Price $191.14 / $265.20 / $300.82	Professional		$191.14	$265.20	$300.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $45.77 / $56.79	Professional	26	$25.26	$45.77	$56.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.24 / $213.69 / $256.89	Professional	TC	$151.24	$213.69	$256.89