Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.15 / $139.15 / $5,581.25	Facility		$139.15	$139.15	$5,581.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.17 / $264.64 / $446.07	Facility	26	$77.17	$264.64	$446.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.15 / $211.53 / $420.30	Professional		$139.15	$211.53	$420.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $75.54 / $475.35	Professional	26	$48.86	$75.54	$475.35
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $65.81 / $69.58 / $464.91	Professional	52	$65.81	$69.58	$464.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.61 / $126.48 / $235.87	Professional	TC	$63.61	$126.48	$235.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $149.29 / $149.29 / $175.73	Professional	26	$149.29	$149.29	$175.73
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,915.20 / $3,950.84 / $7,416.73	Facility		$2,915.20	$3,950.84	$7,416.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $256.50 / $274.18 / $288.04	Professional		$256.50	$274.18	$288.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $133.44 / $148.63 / $152.36	Professional	26	$133.44	$148.63	$152.36
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $117.45 / $125.56 / $131.66	Professional	TC	$117.45	$125.56	$131.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $809.16 / $809.16 / $13,069.00	Facility		$809.16	$809.16	$13,069.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $438.60 / $438.60 / $438.60	Facility	26	$438.60	$438.60	$438.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.61 / $325.00 / $502.67	Professional		$170.61	$325.00	$502.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.94 / $173.87 / $221.07	Professional	26	$93.94	$173.87	$221.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.72 / $148.80 / $251.90	Professional	TC	$88.72	$148.80	$251.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $139.15 / $342.59 / $2,025.75	Facility		$139.15	$342.59	$2,025.75
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $366.35 / $366.35 / $366.35	Facility	26	$366.35	$366.35	$366.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $182.87 / $306.11 / $3,102.49	Professional		$182.87	$306.11	$3,102.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $72.15 / $152.62 / $551.37	Professional	26	$72.15	$152.62	$551.37
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $85.55 / $157.34 / $2,808.09	Professional	TC	$85.55	$157.34	$2,808.09
Midlands Facility/Professional Facility Modifier Low / Median / High Price $277.81 / $320.64 / $671.17	Facility		$277.81	$320.64	$671.17
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $172.21 / $177.22 / $438.60	Facility	26	$172.21	$177.22	$438.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $277.81 / $349.65 / $640.64	Professional		$277.81	$349.65	$640.64
United Facility/Professional Professional Modifier Low / Median / High Price $182.87 / $293.66 / $470.00	Professional		$182.87	$293.66	$470.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.48 / $154.29 / $202.75	Professional	26	$95.48	$154.29	$202.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.55 / $139.02 / $321.89	Professional	TC	$85.55	$139.02	$321.89