Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $114.82 / $165.96	Facility	26	$70.79	$114.82	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $416.87 / $1,122.02	Professional		$245.47	$416.87	$1,122.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $109.65 / $302.00	Professional	26	$52.48	$109.65	$302.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $245.47 / $575.44	Professional	TC	$165.96	$245.47	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $199.53 / $457.09	Professional		$190.55	$199.53	$457.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $77.62 / $120.23	Professional	26	$43.65	$77.62	$120.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $151.36 / $389.05	Professional	TC	$151.36	$151.36	$389.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $389.05 / $537.03	Professional		$234.42	$389.05	$537.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $81.28 / $112.20	Professional	26	$48.98	$81.28	$112.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $309.03 / $426.58	Professional	TC	$186.21	$309.03	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $512.86 / $707.95	Professional		$257.04	$512.86	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $112.20 / $199.53	Professional	26	$52.48	$112.20	$199.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $407.38 / $562.34	Professional	TC	$190.55	$407.38	$562.34
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $380.19 / $380.19 / $380.19	Facility	26	$380.19	$380.19	$380.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $512.86 / $2,344.23	Professional		$302.00	$512.86	$2,344.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $120.23 / $512.86	Professional	26	$89.13	$120.23	$512.86
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $407.38 / $1,862.09	Professional	TC	$257.04	$407.38	$1,862.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $524.81 / $691.83	Professional		$501.19	$524.81	$691.83
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $117.49 / $147.91	Professional	26	$107.15	$117.49	$147.91
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $416.87 / $537.03	Professional	TC	$371.54	$416.87	$537.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $512.86 / $575.44	Professional		$407.38	$512.86	$575.44
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $120.23 / $169.82	Professional	26	$112.20	$120.23	$169.82
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $323.59 / $457.09	Professional	TC	$295.12	$323.59	$457.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $245.47 / $524.81	Professional		$57.54	$245.47	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $489.78 / $676.08	Professional		$281.84	$489.78	$676.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $107.15 / $169.82	Professional	26	$58.88	$107.15	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $389.05 / $537.03	Professional	TC	$223.87	$389.05	$537.03