Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.85 / $61.85 / $302.20	Facility		$61.85	$61.85	$302.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.52 / $17.52 / $17.52	Facility	26	$17.52	$17.52	$17.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.94 / $74.13 / $166.30	Professional		$52.94	$74.13	$166.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.83 / $17.52 / $41.85	Professional	26	$14.83	$17.52	$41.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.11 / $54.36 / $137.21	Professional	TC	$38.11	$54.36	$137.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $668.15 / $864.58 / $1,355.27	Facility		$668.15	$864.58	$1,355.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.25 / $102.06 / $139.19	Professional		$61.25	$102.06	$139.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.34 / $28.30 / $39.43	Professional	26	$17.34	$28.30	$39.43
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.89 / $73.76 / $99.76	Professional	TC	$43.89	$73.76	$99.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $314.00 / $314.00 / $314.00	Facility		$314.00	$314.00	$314.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.07 / $139.80 / $170.66	Professional		$126.07	$139.80	$170.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.94 / $38.90 / $47.87	Professional	26	$34.94	$38.90	$47.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.38 / $102.59 / $121.24	Professional	TC	$90.38	$102.59	$121.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.85 / $105.15 / $271.39	Facility		$61.85	$105.15	$271.39
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $134.26 / $134.26 / $134.26	Facility	26	$134.26	$134.26	$134.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.91 / $152.99 / $803.55	Professional		$102.91	$152.99	$803.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.30 / $36.61 / $416.07	Professional	26	$29.30	$36.61	$416.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $72.70 / $108.08 / $567.25	Professional	TC	$72.70	$108.08	$567.25
Midlands Facility/Professional Facility Modifier Low / Median / High Price $126.07 / $153.33 / $193.98	Facility		$126.07	$153.33	$193.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $115.79 / $153.33 / $250.38	Professional		$115.79	$153.33	$250.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $20.29 / $69.34 / $133.36	Professional		$20.29	$69.34	$133.36
United Facility/Professional Professional Modifier Low / Median / High Price $99.79 / $141.52 / $189.00	Professional		$99.79	$141.52	$189.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.31 / $34.79 / $44.91	Professional	26	$28.31	$34.79	$44.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.70 / $102.68 / $156.12	Professional	TC	$72.70	$102.68	$156.12