Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $316.23 / $933.25	Facility	26	$169.82	$316.23	$933.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $478.63 / $2,187.76	Professional		$346.74	$478.63	$2,187.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $208.93 / $512.86	Professional	26	$97.72	$208.93	$512.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $338.84 / $1,621.81	Professional	TC	$234.42	$338.84	$1,621.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $104.71 / $194.98	Professional	26	$77.62	$104.71	$194.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $436.52 / $436.52	Professional	TC	$436.52	$436.52	$436.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $630.96 / $691.83	Professional		$602.56	$630.96	$691.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $177.83 / $190.55 / $204.17	Professional	26	$177.83	$190.55	$204.17
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $436.52 / $630.96	Professional	TC	$389.05	$436.52	$630.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $562.34 / $562.34 / $562.34	Facility	26	$562.34	$562.34	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $812.83 / $1,348.96	Professional		$331.13	$812.83	$1,348.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $199.53 / $295.12	Professional	26	$93.33	$199.53	$295.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $575.44 / $1,122.02	Professional	TC	$239.88	$575.44	$1,122.02
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $954.99 / $954.99 / $954.99	Facility	26	$954.99	$954.99	$954.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $870.96 / $6,025.60	Professional		$436.52	$870.96	$6,025.60
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $194.98 / $891.25	Professional	26	$123.03	$194.98	$891.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $645.65 / $5,495.41	Professional	TC	$309.03	$645.65	$5,495.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $758.58 / $1,174.90	Professional		$660.69	$758.58	$1,174.90
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $223.87 / $346.74	Professional	26	$194.98	$223.87	$346.74
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $537.03 / $831.76	Professional	TC	$467.74	$537.03	$831.76
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $562.34 / $562.34 / $562.34	Facility	26	$562.34	$562.34	$562.34
Midlands Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,174.90 / $1,862.09	Professional		$758.58	$1,174.90	$1,862.09
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $208.93 / $346.74	Professional	26	$199.53	$208.93	$346.74
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $831.76 / $1,659.59	Professional	TC	$537.03	$831.76	$1,659.59
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $724.44 / $1,258.93	Professional		$416.87	$724.44	$1,258.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $186.21 / $263.03	Professional	26	$109.65	$186.21	$263.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $512.86 / $912.01	Professional	TC	$309.03	$512.86	$912.01