Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $186.21 / $549.54	Facility	26	$109.65	$186.21	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $354.81 / $1,148.15	Professional		$223.87	$354.81	$1,148.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $104.71 / $181.97	Professional	26	$57.54	$104.71	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $257.04 / $436.52	Professional	TC	$158.49	$257.04	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $512.86	Professional		$173.78	$173.78	$512.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $61.66 / $112.20	Professional	26	$45.71	$61.66	$112.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	TC	$123.03	$123.03	$123.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $426.58 / $446.68	Professional		$407.38	$426.58	$446.68
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $112.20 / $120.23	Professional	26	$107.15	$112.20	$120.23
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $316.23 / $346.74	Professional	TC	$186.21	$316.23	$346.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $331.13 / $331.13 / $331.13	Facility	26	$331.13	$331.13	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $524.81 / $707.95	Professional		$199.53	$524.81	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $123.03 / $173.78	Professional	26	$54.95	$123.03	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $389.05 / $524.81	Professional	TC	$144.54	$389.05	$524.81
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $562.34 / $562.34 / $562.34	Facility	26	$562.34	$562.34	$562.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $446.68 / $1,862.09	Professional		$275.42	$446.68	$1,862.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $114.82 / $446.68	Professional	26	$74.13	$114.82	$446.68
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $331.13 / $2,089.30	Professional	TC	$204.17	$331.13	$2,089.30
Midlands Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $501.19 / $794.33	Professional		$446.68	$501.19	$794.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $131.83 / $204.17	Professional	26	$117.49	$131.83	$204.17
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $371.54 / $588.84	Professional	TC	$331.13	$371.54	$588.84
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $331.13 / $331.13 / $331.13	Facility	26	$331.13	$331.13	$331.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $588.84 / $794.33	Professional		$501.19	$588.84	$794.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $123.03 / $204.17	Professional	26	$104.71	$123.03	$204.17
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $457.09 / $588.84	Professional	TC	$371.54	$457.09	$588.84
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $416.87 / $602.56	Professional		$251.19	$416.87	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $112.20 / $154.88	Professional	26	$64.57	$112.20	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $316.23 / $436.52	Professional	TC	$186.21	$316.23	$436.52