Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $72.44 / $218.78	Facility	26	$51.29	$72.44	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $125.89 / $223.87	Professional		$102.33	$125.89	$223.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $22.91 / $43.65	Professional	26	$19.05	$22.91	$43.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $23.44 / $23.44	Professional	26	$23.44	$23.44	$23.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $239.88 / $257.04	Professional		$223.87	$239.88	$257.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $42.66 / $45.71	Professional	26	$40.74	$42.66	$45.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	26	$128.82	$128.82	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $251.19 / $398.11	Professional		$100.00	$251.19	$398.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $47.86 / $66.07	Professional	26	$21.38	$47.86	$66.07
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $190.55 / $891.25	Professional		$117.49	$190.55	$891.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $38.02 / $186.21	Professional	26	$28.84	$38.02	$186.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $281.84 / $446.68	Professional		$257.04	$281.84	$446.68
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $50.12 / $77.62	Professional	26	$44.67	$50.12	$77.62
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	26	$128.82	$128.82	$128.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $165.96 / $446.68	Professional		$162.18	$165.96	$446.68
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $47.86 / $77.62	Professional	26	$39.81	$47.86	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $173.78 / $295.12	Professional		$114.82	$173.78	$295.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $37.15 / $58.88	Professional	26	$25.12	$37.15	$58.88