Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $204.17 / $588.84	Facility	26	$109.65	$204.17	$588.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $275.42 / $457.09	Professional		$173.78	$275.42	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $109.65 / $177.83	Professional	26	$52.48	$109.65	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $199.53 / $338.84	Professional	TC	$123.03	$199.53	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $40.74 / $95.50	Professional	26	$40.74	$40.74	$95.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $338.84 / $363.08	Professional		$323.59	$338.84	$363.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $100.00 / $107.15	Professional	26	$93.33	$100.00	$107.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $234.42 / $371.54	Professional	TC	$186.21	$234.42	$371.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $295.12 / $295.12 / $295.12	Facility	26	$295.12	$295.12	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $426.58 / $575.44	Professional		$208.93	$426.58	$575.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $112.20 / $154.88	Professional	26	$60.26	$112.20	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $302.00 / $446.68	Professional	TC	$147.91	$302.00	$446.68
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $501.19 / $501.19 / $501.19	Facility	26	$501.19	$501.19	$501.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $407.38 / $1,949.84	Professional		$251.19	$407.38	$1,949.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $107.15 / $562.34	Professional	26	$66.07	$107.15	$562.34
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $323.59 / $1,548.82	Professional	TC	$186.21	$323.59	$1,548.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $407.38 / $616.60	Professional		$354.81	$407.38	$616.60
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $117.49 / $181.97	Professional	26	$102.33	$117.49	$181.97
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $288.40 / $436.52	Professional	TC	$245.47	$288.40	$436.52
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $295.12 / $295.12 / $295.12	Facility	26	$295.12	$295.12	$295.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $512.86 / $616.60	Professional		$407.38	$512.86	$616.60
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $120.23 / $181.97	Professional	26	$112.20	$120.23	$181.97
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $380.19 / $436.52	Professional	TC	$288.40	$380.19	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $371.54 / $537.03	Professional		$229.09	$371.54	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $102.33 / $144.54	Professional	26	$60.26	$102.33	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $275.42 / $398.11	Professional	TC	$169.82	$275.42	$398.11