Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $41.69 / $123.03	Facility	26	$21.88	$41.69	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $47.86 / $123.03	Professional		$36.31	$47.86	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $17.78 / $33.88	Professional	26	$10.96	$17.78	$33.88
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	52	$144.54	$144.54	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $30.20 / $77.62	Professional	TC	$22.39	$30.20	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $56.23 / $97.72	Professional		$30.20	$56.23	$97.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $23.44 / $28.84	Professional	26	$10.00	$23.44	$28.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $81.28 / $85.11	Professional		$74.13	$81.28	$85.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $23.99 / $25.70	Professional	26	$22.91	$23.99	$25.70
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $57.54 / $60.26	Professional	TC	$44.67	$57.54	$60.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Facility	26	$72.44	$72.44	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $83.18 / $134.90	Professional		$32.36	$83.18	$134.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $26.92 / $38.02	Professional	26	$12.59	$26.92	$38.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $57.54 / $97.72	Professional	TC	$24.55	$57.54	$97.72
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $79.43 / $79.43	Facility	26	$79.43	$79.43	$79.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $63.10 / $288.40	Professional		$41.69	$63.10	$288.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $22.39 / $83.18	Professional	26	$15.85	$22.39	$83.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $38.90 / $208.93	Professional	TC	$28.84	$38.90	$208.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $95.50 / $154.88	Professional		$83.18	$95.50	$154.88
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $28.18 / $44.67	Professional	26	$25.12	$28.18	$44.67
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $67.61 / $109.65	Professional	TC	$50.12	$67.61	$109.65
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Facility	26	$72.44	$72.44	$72.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $79.43 / $154.88	Professional		$72.44	$79.43	$154.88
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $26.92 / $44.67	Professional	26	$26.30	$26.92	$44.67
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $52.48 / $109.65	Professional	TC	$45.71	$52.48	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $61.66 / $100.00	Professional		$41.69	$61.66	$100.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $20.89 / $33.11	Professional	26	$14.13	$20.89	$33.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $38.90 / $64.57	Professional	TC	$28.84	$38.90	$64.57