Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $870.96 / $1,202.26 / $3,630.78	Facility	26	$870.96	$1,202.26	$3,630.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $3,090.30 / $10,964.78	Professional		$1,698.24	$3,090.30	$10,964.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $398.11 / $870.96 / $1,949.84	Professional	26	$398.11	$870.96	$1,949.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,318.26 / $1,621.81 / $8,511.38	Professional	TC	$1,318.26	$1,621.81	$8,511.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,548.82 / $4,570.88	Professional		$1,380.38	$1,548.82	$4,570.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $338.84 / $501.19 / $831.76	Professional	26	$338.84	$501.19	$831.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $3,311.31 / $3,467.37	Professional		$3,090.30	$3,311.31	$3,467.37
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $724.44 / $776.25 / $812.83	Professional	26	$724.44	$776.25	$812.83
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,348.96 / $2,511.89 / $2,691.53	Professional	TC	$1,348.96	$2,511.89	$2,691.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2,344.23 / $2,344.23 / $2,344.23	Facility	26	$2,344.23	$2,344.23	$2,344.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $4,265.80 / $5,623.41	Professional		$2,951.21	$4,265.80	$5,623.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $588.84 / $977.24 / $1,258.93	Professional	26	$588.84	$977.24	$1,258.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2,398.83 / $3,311.31 / $4,365.16	Professional	TC	$2,398.83	$3,311.31	$4,365.16
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $891.25 / $1,905.46 / $1,905.46	Facility	26	$891.25	$1,905.46	$1,905.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,235.94 / $13,489.63	Professional		$2,137.96	$3,235.94	$13,489.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $478.63 / $776.25 / $1,148.15	Professional	26	$478.63	$776.25	$1,148.15
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $1,659.59 / $2,187.76 / $8,912.51	Professional	TC	$1,659.59	$2,187.76	$8,912.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $3,981.07 / $6,309.57	Professional		$3,467.37	$3,981.07	$6,309.57
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $812.83 / $912.01 / $1,445.44	Professional	26	$812.83	$912.01	$1,445.44
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $2,691.53 / $3,019.95 / $4,897.79	Professional	TC	$2,691.53	$3,019.95	$4,897.79
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $2,344.23 / $2,344.23 / $2,344.23	Facility	26	$2,344.23	$2,344.23	$2,344.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $4,265.80	Professional		$4,168.69	$4,168.69	$4,265.80
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $954.99 / $954.99 / $1,000.00	Professional	26	$954.99	$954.99	$1,000.00
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $3,162.28 / $3,162.28 / $3,311.31	Professional	TC	$3,162.28	$3,162.28	$3,311.31
United Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,235.94 / $4,677.35	Professional		$2,137.96	$3,235.94	$4,677.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $478.63 / $707.95 / $1,071.52	Professional	26	$478.63	$707.95	$1,071.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,659.59 / $2,511.89 / $3,548.13	Professional	TC	$1,659.59	$2,511.89	$3,548.13