Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $169.82 / $501.19	Facility	26	$112.20	$169.82	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $269.15 / $512.86	Professional		$128.82	$269.15	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $102.33 / $141.25	Professional	26	$52.48	$102.33	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $223.87 / $416.87	Professional	TC	$144.54	$223.87	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Professional		$467.74	$467.74	$467.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $58.88 / $125.89	Professional	26	$41.69	$58.88	$125.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $380.19 / $407.38	Professional		$354.81	$380.19	$407.38
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $102.33 / $109.65	Professional	26	$97.72	$102.33	$109.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $275.42 / $338.84	Professional	TC	$251.19	$275.42	$338.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $302.00 / $302.00 / $302.00	Facility	26	$302.00	$302.00	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $457.09 / $616.60	Professional		$186.21	$457.09	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $107.15 / $158.49	Professional	26	$50.12	$107.15	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $346.74 / $446.68	Professional	TC	$134.90	$346.74	$446.68
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $512.86 / $512.86 / $512.86	Facility	26	$512.86	$512.86	$512.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $407.38 / $1,621.81	Professional		$251.19	$407.38	$1,621.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $104.71 / $346.74	Professional	26	$66.07	$104.71	$346.74
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $295.12 / $1,318.26	Professional	TC	$181.97	$295.12	$1,318.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $446.68 / $691.83	Professional		$389.05	$446.68	$691.83
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $120.23 / $186.21	Professional	26	$107.15	$120.23	$186.21
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $331.13 / $501.19	Professional	TC	$281.84	$331.13	$501.19
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $302.00 / $302.00 / $302.00	Facility	26	$302.00	$302.00	$302.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $512.86 / $691.83	Professional		$446.68	$512.86	$691.83
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $112.20 / $186.21	Professional	26	$93.33	$112.20	$186.21
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $398.11 / $501.19	Professional	TC	$331.13	$398.11	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $389.05 / $537.03	Professional		$229.09	$389.05	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $102.33 / $138.04	Professional	26	$58.88	$102.33	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $281.84 / $389.05	Professional	TC	$165.96	$281.84	$389.05