Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $218.78 / $302.00 / $870.96	Facility	26	$218.78	$302.00	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $457.09 / $1,778.28	Professional		$389.05	$457.09	$1,778.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $213.80 / $549.54	Professional	26	$100.00	$213.80	$549.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $354.81 / $1,995.26	Professional	TC	$281.84	$354.81	$1,995.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $812.83	Professional		$309.03	$309.03	$812.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $81.28 / $117.49	Professional	26	$81.28	$81.28	$117.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $741.31 / $776.25	Professional		$691.83	$741.31	$776.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $194.98 / $204.17	Professional	26	$181.97	$194.98	$204.17
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $512.86 / $537.03 / $575.44	Professional	TC	$512.86	$537.03	$575.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $588.84 / $588.84 / $588.84	Facility	26	$588.84	$588.84	$588.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $954.99 / $1,230.27	Professional		$588.84	$954.99	$1,230.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $245.47 / $309.03	Professional	26	$144.54	$245.47	$309.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $691.83 / $912.01	Professional	TC	$446.68	$691.83	$912.01
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $478.63 / $478.63 / $478.63	Facility	26	$478.63	$478.63	$478.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $630.96 / $2,691.53	Professional		$489.78	$630.96	$2,691.53
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $165.96 / $660.69	Professional	26	$123.03	$165.96	$660.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $478.63 / $1,995.26	Professional	TC	$371.54	$478.63	$1,995.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $891.25 / $1,380.38	Professional		$776.25	$891.25	$1,380.38
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $229.09 / $354.81	Professional	26	$204.17	$229.09	$354.81
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $575.44 / $660.69 / $1,000.00	Professional	TC	$575.44	$660.69	$1,000.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $588.84 / $588.84 / $588.84	Facility	26	$588.84	$588.84	$588.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $891.25 / $954.99	Professional		$891.25	$891.25	$954.99
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $239.88 / $239.88 / $251.19	Professional	26	$239.88	$239.88	$251.19
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $660.69 / $660.69 / $691.83	Professional	TC	$660.69	$660.69	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $758.58 / $1,096.48	Professional		$489.78	$758.58	$1,096.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $177.83 / $269.15	Professional	26	$123.03	$177.83	$269.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $549.54 / $831.76	Professional	TC	$371.54	$549.54	$831.76