Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.31 / $42.31 / $42.31	Facility	26	$42.31	$42.31	$42.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.25 / $140.96 / $184.58	Professional		$99.25	$140.96	$184.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.33 / $42.92 / $54.20	Professional	26	$36.33	$42.92	$54.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.92 / $94.80 / $132.30	Professional	TC	$62.92	$94.80	$132.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.70 / $98.70 / $98.70	Professional		$98.70	$98.70	$98.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $98.63 / $98.63 / $98.63	Professional	26	$98.63	$98.63	$98.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.29 / $185.72 / $259.74	Professional		$114.29	$185.72	$259.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.89 / $68.34 / $95.21	Professional	26	$41.89	$68.34	$95.21
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.34 / $117.37 / $164.44	Professional	TC	$72.34	$117.37	$164.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.36 / $263.23 / $321.02	Professional		$229.36	$263.23	$321.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.42 / $94.39 / $115.16	Professional	26	$84.42	$94.39	$115.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.94 / $164.13 / $202.15	Professional	TC	$144.94	$164.13	$202.15
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $198.29 / $198.29 / $198.29	Facility	26	$198.29	$198.29	$198.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $186.08 / $242.00 / $944.58	Professional		$186.08	$242.00	$944.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $71.66 / $89.58 / $386.24	Professional	26	$71.66	$89.58	$386.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $116.60 / $152.41 / $782.04	Professional	TC	$116.60	$152.41	$782.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $199.67 / $270.18 / $348.80	Professional		$199.67	$270.18	$348.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $49.05 / $124.17 / $238.79	Professional		$49.05	$124.17	$238.79
United Facility/Professional Professional Modifier Low / Median / High Price $185.13 / $268.62 / $302.86	Professional		$185.13	$268.62	$302.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.66 / $87.34 / $111.02	Professional	26	$71.66	$87.34	$111.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $121.94 / $152.41 / $191.84	Professional	TC	$121.94	$152.41	$191.84