Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $93.33 / $151.36	Facility	26	$51.29	$93.33	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $112.20 / $239.88	Professional		$83.18	$112.20	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $42.66 / $194.98	Professional	26	$16.60	$42.66	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $63.10 / $158.49	Professional	TC	$43.65	$63.10	$158.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	26	$95.50	$95.50	$95.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $173.78 / $181.97	Professional		$158.49	$173.78	$181.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $83.18 / $87.10	Professional	26	$38.90	$83.18	$87.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $91.20 / $97.72	Professional	TC	$87.10	$91.20	$97.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $251.19 / $251.19 / $251.19	Facility	26	$251.19	$251.19	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $213.80 / $323.59	Professional		$75.86	$213.80	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $69.18 / $131.83	Professional	26	$26.92	$69.18	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $117.49 / $213.80	Professional	TC	$53.70	$117.49	$213.80
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $204.17 / $204.17 / $204.17	Facility	26	$204.17	$204.17	$204.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $199.53 / $2,884.03	Professional		$120.23	$199.53	$2,884.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $57.54 / $426.58	Professional	26	$21.88	$57.54	$426.58
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $120.23 / $2,818.38	Professional	TC	$64.57	$120.23	$2,818.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $204.17 / $323.59	Professional		$181.97	$204.17	$323.59
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $97.72 / $154.88	Professional	26	$39.81	$97.72	$154.88
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $109.65 / $169.82	Professional	TC	$95.50	$109.65	$169.82
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $251.19 / $251.19 / $251.19	Facility	26	$251.19	$251.19	$251.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $323.59 / $891.25	Professional		$208.93	$323.59	$891.25
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $36.31 / $154.88	Professional	26	$34.67	$36.31	$154.88
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $169.82 / $851.14	Professional	TC	$109.65	$169.82	$851.14
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $181.97 / $363.08	Professional		$109.65	$181.97	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $56.23 / $100.00	Professional	26	$21.88	$56.23	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $100.00 / $323.59	Professional	TC	$60.26	$100.00	$323.59