Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.19 / $132.32 / $223.03	Facility	26	$25.19	$132.32	$223.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.43 / $102.85 / $531.00	Professional		$92.43	$102.85	$531.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.03 / $56.86 / $63.32	Professional	26	$24.03	$56.86	$63.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.94 / $78.43 / $162.10	Professional	TC	$67.94	$78.43	$162.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.28 / $49.72 / $49.72	Professional	26	$25.28	$49.72	$49.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.72 / $183.53 / $188.13	Professional		$171.72	$183.53	$188.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.25 / $49.43 / $51.75	Professional	26	$46.25	$49.43	$51.75
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.59 / $134.09 / $137.44	Professional	TC	$123.59	$134.09	$137.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $145.86 / $145.86 / $145.86	Facility	26	$145.86	$145.86	$145.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.72 / $211.35 / $290.89	Professional		$96.72	$211.35	$290.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.47 / $57.82 / $74.66	Professional	26	$30.47	$57.82	$74.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.22 / $154.61 / $216.23	Professional	TC	$71.22	$154.61	$216.23
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $118.08 / $118.08 / $118.08	Facility	26	$118.08	$118.08	$118.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $106.57 / $177.25 / $642.13	Professional		$106.57	$177.25	$642.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.45 / $52.73 / $167.46	Professional	26	$32.45	$52.73	$167.46
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $74.12 / $125.76 / $474.67	Professional	TC	$74.12	$125.76	$474.67
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $83.46 / $85.89 / $145.86	Facility	26	$83.46	$85.89	$145.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $151.00 / $205.33 / $249.80	Professional		$151.00	$205.33	$249.80
United Facility/Professional Professional Modifier Low / Median / High Price $106.57 / $179.05 / $222.03	Professional		$106.57	$179.05	$222.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.45 / $52.11 / $66.33	Professional	26	$32.45	$52.11	$66.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.12 / $125.76 / $151.52	Professional	TC	$74.12	$125.76	$151.52