Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.82 / $814.53 / $1,230.46	Facility		$194.82	$814.53	$1,230.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $37.90 / $65.81	Facility	26	$19.95	$37.90	$65.81
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $97.30 / $273.06 / $1,089.76	Facility	TC	$97.30	$273.06	$1,089.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.23 / $116.56 / $483.75	Professional		$22.23	$116.56	$483.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.55 / $34.14 / $95.79	Professional	26	$19.55	$34.14	$95.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.64 / $105.31 / $218.50	Professional	TC	$89.64	$105.31	$218.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.53 / $117.85 / $256.38	Professional		$92.53	$117.85	$256.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.51 / $27.37 / $46.30	Professional	26	$15.51	$27.37	$46.30
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $96.56 / $178.48 / $210.08	Professional	TC	$96.56	$178.48	$210.08
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 $106.19 / $175.56 / $241.33	Professional		$106.19	$175.56	$241.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.02 / $32.09 / $43.22	Professional	26	$19.02	$32.09	$43.22
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.17 / $144.12 / $198.09	Professional	TC	$87.17	$144.12	$198.09
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 $118.80 / $249.85 / $312.31	Professional		$118.80	$249.85	$312.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.15 / $45.39 / $57.31	Professional	26	$23.15	$45.39	$57.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.38 / $207.97 / $259.97	Professional	TC	$100.38	$207.97	$259.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $160.85 / $545.21 / $1,271.57	Facility		$160.85	$545.21	$1,271.57
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $107.00 / $107.00 / $107.00	Facility	26	$107.00	$107.00	$107.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $442.03 / $840.60 / $1,273.30	Facility	TC	$442.03	$840.60	$1,273.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $181.47 / $239.00 / $1,052.95	Professional		$181.47	$239.00	$1,052.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.43 / $41.85 / $62.08	Professional	26	$33.43	$41.85	$62.08
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $147.13 / $196.37 / $927.48	Professional	TC	$147.13	$196.37	$927.48
Midlands Facility/Professional Facility Modifier Low / Median / High Price $221.26 / $264.14 / $303.85	Facility		$221.26	$264.14	$303.85
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $172.44 / $172.44 / $172.44	Facility	TC	$172.44	$172.44	$172.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $175.16 / $233.12 / $298.58	Professional		$175.16	$233.12	$298.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.69 / $120.32 / $218.20	Professional		$22.69	$120.32	$218.20
United Facility/Professional Professional Modifier Low / Median / High Price $173.53 / $245.46 / $290.69	Professional		$173.53	$245.46	$290.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.11 / $41.34 / $52.64	Professional	26	$34.11	$41.34	$52.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.13 / $208.69 / $238.34	Professional	TC	$147.13	$208.69	$238.34