Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $104.71 / $309.03	Facility	26	$77.62	$104.71	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $389.05 / $1,047.13	Professional		$229.09	$389.05	$1,047.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $79.43 / $169.82	Professional	26	$36.31	$79.43	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $263.03 / $1,000.00	Professional	TC	$213.80	$263.03	$1,000.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $213.80 / $630.96	Professional		$199.53	$213.80	$630.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $56.23 / $89.13	Professional	26	$41.69	$56.23	$89.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $478.63 / $512.86	Professional		$457.09	$478.63	$512.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $69.18 / $72.44	Professional	26	$64.57	$69.18	$72.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $407.38 / $436.52	Professional	TC	$131.83	$407.38	$436.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $208.93 / $208.93 / $208.93	Facility	26	$208.93	$208.93	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $602.56 / $812.83	Professional		$269.15	$602.56	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $87.10 / $112.20	Professional	26	$52.48	$87.10	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $512.86 / $707.95	Professional	TC	$218.78	$512.86	$707.95
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $467.74 / $467.74 / $467.74	Facility	26	$467.74	$467.74	$467.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $416.87 / $2,398.83	Professional		$204.17	$416.87	$2,398.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $67.61 / $100.00	Professional	26	$41.69	$67.61	$100.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $354.81 / $1,659.59	Professional	TC	$162.18	$354.81	$1,659.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $575.44 / $912.01	Professional		$512.86	$575.44	$912.01
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $81.28 / $128.82	Professional	26	$72.44	$81.28	$128.82
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $489.78 / $776.25	Professional	TC	$436.52	$489.78	$776.25
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $208.93 / $208.93 / $208.93	Facility	26	$208.93	$208.93	$208.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $630.96	Professional		$602.56	$602.56	$630.96
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $85.11 / $89.13	Professional	26	$85.11	$85.11	$89.13
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $512.86 / $512.86 / $537.03	Professional	TC	$512.86	$512.86	$537.03
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $416.87 / $676.08	Professional		$204.17	$416.87	$676.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $63.10 / $95.50	Professional	26	$41.69	$63.10	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $389.05 / $575.44	Professional	TC	$162.18	$389.05	$575.44