Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.10 / $20.17 / $54.49	Facility	26	$6.10	$20.17	$54.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.41 / $117.00 / $199.24	Facility	TC	$28.41	$117.00	$199.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.04 / $36.13 / $121.00	Professional		$15.04	$36.13	$121.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.87 / $13.69 / $26.00	Professional	26	$5.87	$13.69	$26.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.13 / $43.00 / $101.00	Professional	TC	$21.13	$43.00	$101.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.61 / $62.77 / $62.77	Professional		$20.61	$62.77	$62.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.48 / $10.71 / $14.11	Professional	26	$6.48	$10.71	$14.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $41.34 / $41.34 / $41.34	Professional	TC	$41.34	$41.34	$41.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.15 / $53.61 / $54.96	Professional		$50.15	$53.61	$54.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $11.90 / $12.50	Professional	26	$11.14	$11.90	$12.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.03 / $41.71 / $42.75	Professional	TC	$39.03	$41.71	$42.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.15 / $35.15 / $35.15	Facility	26	$35.15	$35.15	$35.15
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $123.12 / $123.12 / $123.12	Facility	TC	$123.12	$123.12	$123.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.36 / $61.91 / $84.36	Professional		$28.36	$61.91	$84.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.52 / $13.89 / $17.45	Professional	26	$7.52	$13.89	$17.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.18 / $47.92 / $66.90	Professional	TC	$24.18	$47.92	$66.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $102.96 / $163.80 / $267.89	Facility	TC	$102.96	$163.80	$267.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.07 / $50.49 / $187.25	Professional		$31.07	$50.49	$187.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.72 / $12.48 / $54.49	Professional	26	$7.72	$12.48	$54.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.35 / $38.74 / $146.99	Professional	TC	$23.35	$38.74	$146.99
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $20.48 / $21.07 / $35.15	Facility	26	$20.48	$21.07	$35.15
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $39.94 / $77.66 / $123.12	Facility	TC	$39.94	$77.66	$123.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $61.52 / $73.26	Professional		$41.00	$61.52	$73.26
United Facility/Professional Professional Modifier Low / Median / High Price $31.07 / $50.49 / $63.51	Professional		$31.07	$50.49	$63.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.72 / $12.39 / $15.77	Professional	26	$7.72	$12.39	$15.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $37.50 / $47.74	Professional	TC	$21.88	$37.50	$47.74