Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $175.75 / $175.75 / $175.75	Facility	26	$175.75	$175.75	$175.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $270.29 / $309.73 / $679.38	Professional		$270.29	$309.73	$679.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $171.18 / $188.30 / $439.70	Professional	26	$171.18	$188.30	$439.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.55 / $115.98 / $151.69	Professional	TC	$94.55	$115.98	$151.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $477.87 / $516.62 / $678.52	Professional		$477.87	$516.62	$678.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $279.06 / $329.80 / $412.10	Professional	26	$279.06	$329.80	$412.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.63 / $438.54 / $608.25	Professional		$267.63	$438.54	$608.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $174.03 / $284.44 / $395.50	Professional	26	$174.03	$284.44	$395.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.62 / $154.09 / $212.78	Professional	TC	$93.62	$154.09	$212.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $541.54 / $621.09 / $743.84	Professional		$541.54	$621.09	$743.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $351.25 / $393.41 / $475.52	Professional	26	$351.25	$393.41	$475.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.30 / $222.95 / $268.69	Professional	TC	$190.30	$222.95	$268.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $829.58 / $829.58 / $829.58	Facility	26	$829.58	$829.58	$829.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $464.64 / $607.92 / $1,850.58	Professional		$464.64	$607.92	$1,850.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $298.39 / $392.06 / $1,166.03	Professional	26	$298.39	$392.06	$1,166.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $171.46 / $225.69 / $684.55	Professional	TC	$171.46	$225.69	$684.55
Midlands Facility/Professional Professional Modifier Low / Median / High Price $444.44 / $593.69 / $767.80	Professional		$444.44	$593.69	$767.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.77 / $302.22 / $581.20	Professional		$120.77	$302.22	$581.20
United Facility/Professional Professional Modifier Low / Median / High Price $479.16 / $622.36 / $712.35	Professional		$479.16	$622.36	$712.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $306.16 / $392.06 / $455.15	Professional	26	$306.16	$392.06	$455.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.00 / $225.48 / $257.20	Professional	TC	$173.00	$225.48	$257.20