Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $102.33 / $426.58	Facility	26	$58.88	$102.33	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $141.25 / $380.19	Professional		$47.86	$141.25	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $93.33 / $186.21	Professional	26	$44.67	$93.33	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $177.83 / $630.96	Professional	TC	$97.72	$177.83	$630.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $114.82 / $354.81	Professional		$112.20	$114.82	$354.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $64.57 / $100.00	Professional	26	$36.31	$64.57	$100.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $83.18 / $134.90	Professional	TC	$83.18	$83.18	$134.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $281.84 / $295.12	Professional		$263.03	$281.84	$295.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $87.10 / $93.33	Professional	26	$83.18	$87.10	$93.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $190.55 / $223.87	Professional	TC	$112.20	$190.55	$223.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	26	$263.03	$263.03	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $354.81 / $489.78	Professional		$151.36	$354.81	$489.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $100.00 / $138.04	Professional	26	$43.65	$100.00	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $245.47 / $354.81	Professional	TC	$107.15	$245.47	$354.81
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $323.59 / $1,380.38	Professional		$199.53	$323.59	$1,380.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $91.20 / $302.00	Professional	26	$58.88	$91.20	$302.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $229.09 / $1,096.48	Professional	TC	$141.25	$229.09	$1,096.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $331.13 / $537.03	Professional		$288.40	$331.13	$537.03
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $104.71 / $158.49	Professional	26	$91.20	$104.71	$158.49
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $234.42 / $371.54	Professional	TC	$199.53	$234.42	$371.54
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	26	$263.03	$263.03	$263.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $436.52 / $537.03	Professional		$331.13	$436.52	$537.03
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $107.15 / $158.49	Professional	26	$89.13	$107.15	$158.49
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $331.13 / $371.54	Professional	TC	$229.09	$331.13	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $309.03 / $436.52	Professional		$181.97	$309.03	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $89.13 / $123.03	Professional	26	$51.29	$89.13	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $223.87 / $309.03	Professional	TC	$128.82	$223.87	$309.03