Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $85.11 / $251.19	Facility	26	$33.11	$85.11	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $131.83 / $501.19	Professional		$66.07	$131.83	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $51.29 / $69.18	Professional	26	$25.70	$51.29	$69.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $89.13 / $338.84	Professional	TC	$42.66	$89.13	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $81.28	Professional		$75.86	$75.86	$81.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $30.20 / $52.48	Professional	26	$25.70	$30.20	$52.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $181.97 / $194.98	Professional		$177.83	$181.97	$194.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $51.29 / $53.70	Professional	26	$47.86	$51.29	$53.70
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $134.90 / $141.25	Professional	TC	$125.89	$134.90	$141.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $151.36 / $151.36	Facility	26	$151.36	$151.36	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $199.53 / $309.03	Professional		$87.10	$199.53	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $58.88 / $81.28	Professional	26	$25.12	$58.88	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $144.54 / $223.87	Professional	TC	$61.66	$144.54	$223.87
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $257.04 / $257.04 / $257.04	Facility	26	$257.04	$257.04	$257.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $177.83 / $660.69	Professional		$97.72	$177.83	$660.69
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $52.48 / $79.43	Professional	26	$31.62	$52.48	$79.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $128.82 / $489.78	Professional	TC	$66.07	$128.82	$489.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $218.78 / $346.74	Professional		$194.98	$218.78	$346.74
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $60.26 / $93.33	Professional	26	$52.48	$60.26	$93.33
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $158.49 / $251.19	Professional	TC	$134.90	$158.49	$251.19
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $151.36 / $151.36	Facility	26	$151.36	$151.36	$151.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $229.09 / $346.74	Professional		$104.71	$229.09	$346.74
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $61.66 / $93.33	Professional	26	$40.74	$61.66	$93.33
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $165.96 / $251.19	Professional	TC	$66.07	$165.96	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $181.97 / $223.87	Professional		$91.20	$181.97	$223.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $50.12 / $67.61	Professional	26	$29.51	$50.12	$67.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $128.82 / $165.96	Professional	TC	$66.07	$128.82	$165.96