Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.98 / $54.88 / $143.38	Facility	26	$12.98	$54.88	$143.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.36 / $125.33 / $220.36	Facility	TC	$30.36	$125.33	$220.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.85 / $47.25 / $248.06	Professional		$41.85	$47.25	$248.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.98 / $37.19 / $80.12	Professional	26	$12.98	$37.19	$80.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.17 / $28.86 / $74.98	Professional	TC	$28.17	$28.86	$74.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.91 / $13.95 / $30.26	Professional	26	$13.91	$13.95	$30.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.20 / $82.54 / $84.59	Professional		$77.20	$82.54	$84.59
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.91 / $25.55 / $26.87	Professional	26	$23.91	$25.55	$26.87
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.31 / $56.97 / $58.39	Professional	TC	$53.31	$56.97	$58.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.42 / $75.42 / $75.42	Facility	26	$75.42	$75.42	$75.42
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $168.12 / $168.12 / $168.12	Facility	TC	$168.12	$168.12	$168.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.87 / $95.88 / $129.93	Professional		$44.87	$95.88	$129.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.68 / $29.84 / $40.69	Professional	26	$15.68	$29.84	$40.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.72 / $66.05 / $92.11	Professional	TC	$32.72	$66.05	$92.11
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $142.32 / $142.32 / $142.32	Facility	TC	$142.32	$142.32	$142.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.37 / $81.14 / $314.00	Professional		$49.37	$81.14	$314.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.97 / $27.52 / $107.32	Professional	26	$16.97	$27.52	$107.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.40 / $52.65 / $296.00	Professional	TC	$32.40	$52.65	$296.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $51.63 / $53.14 / $75.42	Facility	26	$51.63	$53.14	$75.42
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $55.36 / $102.49 / $168.12	Facility	TC	$55.36	$102.49	$168.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.62 / $95.35 / $119.30	Professional		$83.62	$95.35	$119.30
United Facility/Professional Professional Modifier Low / Median / High Price $49.37 / $80.22 / $100.92	Professional		$49.37	$80.22	$100.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.97 / $27.52 / $34.69	Professional	26	$16.97	$27.52	$34.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.40 / $52.65 / $66.23	Professional	TC	$32.40	$52.65	$66.23