Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $255.06 / $1,220.98 / $1,801.68	Facility		$255.06	$1,220.98	$1,801.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.07 / $59.03 / $104.98	Facility	26	$31.07	$59.03	$104.98
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $143.61 / $418.60 / $1,166.76	Facility	TC	$143.61	$418.60	$1,166.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.69 / $300.00 / $912.00	Professional		$174.69	$300.00	$912.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.07 / $49.73 / $149.00	Professional	26	$31.07	$49.73	$149.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $143.61 / $167.34 / $427.06	Professional	TC	$143.61	$167.34	$427.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.57 / $144.57 / $400.38	Professional		$144.57	$144.57	$400.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.04 / $32.89 / $63.62	Professional	26	$24.04	$32.89	$63.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $151.15 / $151.15 / $328.84	Professional	TC	$151.15	$151.15	$328.84
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 $166.61 / $281.07 / $378.66	Professional		$166.61	$281.07	$378.66
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.48 / $49.74 / $67.01	Professional	26	$29.48	$49.74	$67.01
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $137.13 / $229.96 / $311.64	Professional	TC	$137.13	$229.96	$311.64
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 $190.99 / $397.55 / $487.66	Professional		$190.99	$397.55	$487.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.82 / $71.31 / $87.91	Professional	26	$35.82	$71.31	$87.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $163.95 / $330.48 / $405.65	Professional	TC	$163.95	$330.48	$405.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $200.43 / $428.22 / $1,604.78	Facility		$200.43	$428.22	$1,604.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $212.00 / $212.00 / $212.00	Facility	26	$212.00	$212.00	$212.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $691.80 / $691.80 / $2,012.01	Facility	TC	$691.80	$691.80	$2,012.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $277.27 / $370.57 / $1,578.90	Professional		$277.27	$370.57	$1,578.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $50.61 / $64.51 / $131.32	Professional	26	$50.61	$64.51	$131.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $237.04 / $315.42 / $1,388.59	Professional	TC	$237.04	$315.42	$1,388.59
Midlands Facility/Professional Facility Modifier Low / Median / High Price $347.19 / $417.85 / $481.77	Facility		$347.19	$417.85	$481.77
Midlands Facility/Professional Professional Modifier Low / Median / High Price $286.82 / $380.00 / $481.77	Professional		$286.82	$380.00	$481.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.39 / $190.79 / $340.56	Professional		$35.39	$190.79	$340.56
United Facility/Professional Professional Modifier Low / Median / High Price $277.27 / $402.33 / $444.56	Professional		$277.27	$402.33	$444.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.61 / $71.40 / $81.15	Professional	26	$50.61	$71.40	$81.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $237.04 / $300.56 / $376.86	Professional	TC	$237.04	$300.56	$376.86