Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.81 / $42.81 / $42.81	Facility	26	$42.81	$42.81	$42.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.77 / $110.19 / $607.21	Professional		$84.77	$110.19	$607.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.81 / $50.34 / $217.08	Professional	26	$42.81	$50.34	$217.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $392.92 / $392.92 / $392.92	Professional	50	$392.92	$392.92	$392.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.92 / $48.88 / $63.77	Professional	TC	$39.92	$48.88	$63.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.77 / $175.47 / $206.55	Professional		$84.77	$175.47	$206.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.91 / $80.26 / $100.29	Professional	26	$67.91	$80.26	$100.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.70 / $147.13 / $206.15	Professional		$90.70	$147.13	$206.15
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.39 / $69.01 / $96.34	Professional	26	$42.39	$69.01	$96.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.17 / $78.14 / $109.48	Professional	TC	$48.17	$78.14	$109.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.65 / $202.28 / $238.31	Professional		$177.65	$202.28	$238.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.22 / $95.84 / $116.26	Professional	26	$85.22	$95.84	$116.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.20 / $105.38 / $119.91	Professional	TC	$88.20	$105.38	$119.91
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $201.33 / $201.33 / $201.33	Facility	26	$201.33	$201.33	$201.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $147.78 / $184.72 / $247.09	Professional		$147.78	$184.72	$247.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $74.45 / $95.46 / $129.50	Professional	26	$74.45	$95.46	$129.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $67.75 / $92.12 / $358.05	Professional	TC	$67.75	$92.12	$358.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $135.27 / $183.83 / $257.01	Professional		$135.27	$183.83	$257.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.94 / $97.97 / $191.33	Professional		$50.94	$97.97	$191.33
United Facility/Professional Professional Modifier Low / Median / High Price $144.86 / $185.71 / $230.17	Professional		$144.86	$185.71	$230.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.45 / $97.33 / $110.68	Professional	26	$74.45	$97.33	$110.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.58 / $92.12 / $117.59	Professional	TC	$75.58	$92.12	$117.59