Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $58.88 / $61.66	Facility	26	$27.54	$58.88	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $53.70 / $204.17	Professional		$42.66	$53.70	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $28.84 / $70.79	Professional	26	$23.99	$28.84	$70.79
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $38.90 / $38.90 / $38.90	Professional	52	$38.90	$38.90	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $24.55 / $67.61	Professional	TC	$19.05	$24.55	$67.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $42.66 / $95.50	Professional		$31.62	$42.66	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $29.51 / $64.57	Professional	26	$21.38	$29.51	$64.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $15.14 / $28.84	Professional	TC	$15.14	$15.14	$28.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $87.10 / $102.33	Professional		$83.18	$87.10	$102.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $52.48 / $57.54	Professional	26	$50.12	$52.48	$57.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $34.67 / $45.71	Professional	TC	$33.11	$34.67	$45.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $48.98 / $112.20	Professional		$38.90	$48.98	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $35.48 / $67.61	Professional	26	$25.12	$35.48	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $22.39 / $44.67	Professional	TC	$14.13	$22.39	$44.67
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Facility	26	$141.25	$141.25	$141.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $77.62 / $331.13	Professional		$63.10	$77.62	$331.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $48.98 / $181.97	Professional	26	$34.67	$48.98	$181.97
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $37.15 / $151.36	Professional	TC	$27.54	$37.15	$151.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $87.10 / $131.83	Professional		$64.57	$87.10	$131.83
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $48.98 / $74.13	Professional	26	$41.69	$48.98	$74.13
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $38.02 / $58.88	Professional	TC	$22.91	$38.02	$58.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $100.00 / $112.20	Professional		$87.10	$100.00	$112.20
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $64.57 / $67.61	Professional	26	$48.98	$64.57	$67.61
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $38.90 / $44.67	Professional	TC	$34.67	$38.90	$44.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $30.20 / $70.79	Professional		$12.59	$30.20	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $77.62 / $128.82	Professional		$61.66	$77.62	$128.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $43.65 / $72.44	Professional	26	$33.88	$43.65	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $33.88 / $57.54	Professional	TC	$27.54	$33.88	$57.54