Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $144.54 / $416.87	Facility	26	$93.33	$144.54	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $162.18 / $323.59	Professional		$123.03	$162.18	$323.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $61.66 / $117.49	Professional	26	$42.66	$61.66	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $104.71 / $218.78	Professional	TC	$75.86	$104.71	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Professional	26	$107.15	$107.15	$107.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $245.47 / $251.19	Professional		$229.09	$245.47	$251.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $83.18 / $89.13	Professional	26	$79.43	$83.18	$89.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $158.49 / $165.96	Professional	TC	$151.36	$158.49	$165.96
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 $120.23 / $281.84 / $398.11	Professional		$120.23	$281.84	$398.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $95.50 / $131.83	Professional	26	$41.69	$95.50	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $194.98 / $269.15	Professional	TC	$79.43	$194.98	$269.15
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $426.58 / $426.58 / $426.58	Facility	26	$426.58	$426.58	$426.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $263.03 / $1,047.13	Professional		$162.18	$263.03	$1,047.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $87.10 / $288.40	Professional	26	$56.23	$87.10	$288.40
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $173.78 / $776.25	Professional	TC	$107.15	$173.78	$776.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $269.15 / $446.68	Professional		$245.47	$269.15	$446.68
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $100.00 / $151.36	Professional	26	$87.10	$100.00	$151.36
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $169.82 / $302.00	Professional	TC	$134.90	$169.82	$302.00
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 $269.15 / $323.59 / $446.68	Professional		$269.15	$323.59	$446.68
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $95.50 / $151.36	Professional	26	$93.33	$95.50	$151.36
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $234.42 / $302.00	Professional	TC	$169.82	$234.42	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $251.19 / $354.81	Professional		$147.91	$251.19	$354.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $85.11 / $114.82	Professional	26	$48.98	$85.11	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $165.96 / $229.09	Professional	TC	$97.72	$165.96	$229.09