Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $213.80 / $630.96	Facility	26	$141.25	$213.80	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $436.52 / $1,737.80	Professional		$257.04	$436.52	$1,737.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $141.25 / $181.97	Professional	26	$70.79	$141.25	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $302.00 / $758.58	Professional	TC	$190.55	$302.00	$758.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $117.49 / $158.49	Professional	26	$56.23	$117.49	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $501.19 / $537.03	Professional		$467.74	$501.19	$537.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $128.82 / $138.04	Professional	26	$123.03	$128.82	$138.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $363.08 / $467.74	Professional	TC	$251.19	$363.08	$467.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $389.05 / $389.05 / $389.05	Facility	26	$389.05	$389.05	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $630.96 / $870.96	Professional		$263.03	$630.96	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $134.90 / $199.53	Professional	26	$63.10	$134.90	$199.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $467.74 / $660.69	Professional	TC	$199.53	$467.74	$660.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $660.69 / $660.69 / $660.69	Facility	26	$660.69	$660.69	$660.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $562.34 / $2,884.03	Professional		$346.74	$562.34	$2,884.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $138.04 / $549.54	Professional	26	$85.11	$138.04	$549.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $446.68 / $2,511.89	Professional	TC	$257.04	$446.68	$2,511.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $602.56 / $912.01	Professional		$512.86	$602.56	$912.01
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $154.88 / $234.42	Professional	26	$134.90	$154.88	$234.42
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $446.68 / $660.69	Professional	TC	$380.19	$446.68	$660.69
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $389.05 / $389.05 / $389.05	Facility	26	$389.05	$389.05	$389.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $870.96 / $912.01	Professional		$588.84	$870.96	$912.01
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $144.54 / $234.42	Professional	26	$131.83	$144.54	$234.42
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $660.69 / $758.58	Professional	TC	$436.52	$660.69	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $537.03 / $758.58	Professional		$316.23	$537.03	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $128.82 / $177.83	Professional	26	$75.86	$128.82	$177.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $416.87 / $562.34	Professional	TC	$239.88	$416.87	$562.34