Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.38 / $15.30 / $21.62	Facility	26	$11.38	$15.30	$21.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.23 / $54.53 / $117.37	Professional		$50.23	$54.53	$117.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.24 / $14.79 / $48.08	Professional	26	$11.24	$14.79	$48.08
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.12 / $27.10 / $45.51	Professional	52	$25.12	$27.10	$45.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.86 / $42.49 / $69.53	Professional	TC	$38.86	$42.49	$69.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.73 / $104.60 / $123.12	Professional		$45.73	$104.60	$123.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.85 / $22.52 / $26.51	Professional	26	$14.85	$22.52	$26.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.96 / $84.31 / $113.56	Professional		$49.96	$84.31	$113.56
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.89 / $18.37 / $24.75	Professional	26	$10.89	$18.37	$24.75
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.07 / $65.93 / $88.81	Professional	TC	$39.07	$65.93	$88.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.08 / $119.34 / $232.77	Professional		$69.08	$119.34	$232.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.16 / $25.00 / $46.28	Professional	26	$17.16	$25.00	$46.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.92 / $95.61 / $186.49	Professional	TC	$51.92	$95.61	$186.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $27.92 / $80.00 / $80.00	Facility	26	$27.92	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.89 / $109.75 / $346.85	Professional		$79.89	$109.75	$346.85
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.38 / $24.86 / $74.58	Professional	26	$19.38	$24.86	$74.58
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $60.51 / $75.64 / $272.27	Professional	TC	$60.51	$75.64	$272.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $77.01 / $104.55 / $135.55	Professional		$77.01	$104.55	$135.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.53 / $69.01 / $120.32	Professional		$13.53	$69.01	$120.32
United Facility/Professional Professional Modifier Low / Median / High Price $68.13 / $105.63 / $122.48	Professional		$68.13	$105.63	$122.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.89 / $24.08 / $29.71	Professional	26	$13.89	$24.08	$29.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.23 / $79.25 / $97.51	Professional	TC	$52.23	$79.25	$97.51