Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.76 / $251.23 / $975.04	Facility		$108.76	$251.23	$975.04
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.64 / $54.78 / $73.94	Facility	26	$21.64	$54.78	$73.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.86 / $122.76 / $593.00	Professional		$103.86	$122.76	$593.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $22.82 / $105.00	Professional	26	$20.50	$22.82	$105.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.12 / $102.26 / $155.07	Professional	TC	$87.12	$102.26	$155.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.69 / $23.69 / $23.69	Professional	26	$23.69	$23.69	$23.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $171.11 / $171.11 / $171.11	Professional	TC	$171.11	$171.11	$171.11
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 $104.83 / $173.34 / $238.25	Professional		$104.83	$173.34	$238.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.93 / $35.29 / $47.56	Professional	26	$20.93	$35.29	$47.56
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.90 / $138.72 / $190.68	Professional	TC	$83.90	$138.72	$190.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.04 / $250.97 / $306.20	Professional		$118.04	$250.97	$306.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.24 / $48.17 / $61.80	Professional	26	$25.24	$48.17	$61.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.49 / $204.61 / $248.63	Professional	TC	$97.49	$204.61	$248.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $108.76 / $190.33 / $288.22	Facility		$108.76	$190.33	$288.22
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $104.46 / $104.46 / $104.46	Facility	26	$104.46	$104.46	$104.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $175.89 / $241.67 / $1,013.21	Professional		$175.89	$241.67	$1,013.21
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.61 / $44.46 / $217.94	Professional	26	$35.61	$44.46	$217.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $142.03 / $199.73 / $889.85	Professional	TC	$142.03	$199.73	$889.85
Midlands Facility/Professional Facility Modifier Low / Median / High Price $218.46 / $266.02 / $306.73	Facility		$218.46	$266.02	$306.73
Midlands Facility/Professional Professional Modifier Low / Median / High Price $173.94 / $250.97 / $306.73	Professional		$173.94	$250.97	$306.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $209.90 / $307.39 / $353.50	Professional		$209.90	$307.39	$353.50
United Facility/Professional Professional Modifier Low / Median / High Price $171.38 / $248.66 / $285.39	Professional		$171.38	$248.66	$285.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.56 / $45.32 / $57.01	Professional	26	$35.56	$45.32	$57.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $137.44 / $199.73 / $236.36	Professional	TC	$137.44	$199.73	$236.36