Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $50.12 / $50.12	Facility	26	$50.12	$50.12	$50.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $223.87 / $549.54	Professional		$186.21	$223.87	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $54.95 / $141.25	Professional	26	$45.71	$54.95	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $165.96 / $389.05	Professional	TC	$138.04	$165.96	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Professional		$218.78	$218.78	$218.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $117.49 / $117.49	Professional	26	$117.49	$117.49	$117.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $371.54 / $389.05	Professional		$354.81	$371.54	$389.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $95.50 / $100.00	Professional	26	$91.20	$95.50	$100.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $275.42 / $302.00	Professional	TC	$251.19	$275.42	$302.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $288.40 / $288.40 / $288.40	Facility	26	$288.40	$288.40	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $436.52 / $602.56	Professional		$158.49	$436.52	$602.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $109.65 / $151.36	Professional	26	$42.66	$109.65	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $288.40 / $457.09	Professional	TC	$117.49	$288.40	$457.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $234.42 / $234.42 / $234.42	Facility	26	$234.42	$234.42	$234.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $416.87 / $1,380.38	Professional		$257.04	$416.87	$1,380.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $102.33 / $331.13	Professional	26	$64.57	$102.33	$331.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $309.03 / $1,047.13	Professional	TC	$194.98	$309.03	$1,047.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $457.09 / $691.83	Professional		$389.05	$457.09	$691.83
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $114.82 / $173.78	Professional	26	$100.00	$114.82	$173.78
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $338.84 / $512.86	Professional	TC	$288.40	$338.84	$512.86
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $288.40 / $288.40 / $288.40	Facility	26	$288.40	$288.40	$288.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $446.68 / $691.83	Professional		$389.05	$446.68	$691.83
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $117.49 / $173.78	Professional	26	$100.00	$117.49	$173.78
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $331.13 / $512.86	Professional	TC	$288.40	$331.13	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $398.11 / $537.03	Professional		$234.42	$398.11	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $97.72 / $134.90	Professional	26	$57.54	$97.72	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $295.12 / $407.38	Professional	TC	$177.83	$295.12	$407.38