Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $316.23 / $436.52 / $1,288.25	Facility	26	$316.23	$436.52	$1,288.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $309.03 / $1,584.89	Professional		$218.78	$309.03	$1,584.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $323.59 / $831.76	Professional	26	$147.91	$323.59	$831.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $151.36 / $891.25	Professional	TC	$123.03	$151.36	$891.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $691.83	Professional		$234.42	$234.42	$691.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $173.78 / $363.08	Professional	26	$123.03	$173.78	$363.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $524.81 / $549.54	Professional		$489.78	$524.81	$549.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $281.84 / $295.12	Professional	26	$263.03	$281.84	$295.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $245.47 / $676.08	Professional	TC	$229.09	$245.47	$676.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $851.14 / $851.14 / $851.14	Facility	26	$851.14	$851.14	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $660.69 / $870.96	Professional		$389.05	$660.69	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $354.81 / $457.09	Professional	26	$208.93	$354.81	$457.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $302.00 / $416.87	Professional	TC	$177.83	$302.00	$416.87
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $691.83 / $691.83 / $691.83	Facility	26	$691.83	$691.83	$691.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $436.52 / $758.58	Professional		$331.13	$436.52	$758.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $257.04 / $416.87	Professional	26	$181.97	$257.04	$416.87
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $186.21 / $831.76	Professional	TC	$151.36	$186.21	$831.76
Midlands Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $616.60 / $1,000.00	Professional		$549.54	$616.60	$1,000.00
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $295.12 / $331.13 / $524.81	Professional	26	$295.12	$331.13	$524.81
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $295.12 / $467.74	Professional	TC	$257.04	$295.12	$467.74
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $851.14 / $851.14 / $851.14	Facility	26	$851.14	$851.14	$851.14
Midlands Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $676.08	Professional		$660.69	$660.69	$676.08
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $346.74 / $346.74 / $363.08	Professional	26	$346.74	$346.74	$363.08
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $302.00 / $309.03	Professional	TC	$302.00	$302.00	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $478.63 / $707.95	Professional		$331.13	$478.63	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $177.83 / $257.04 / $389.05	Professional	26	$177.83	$257.04	$389.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $218.78 / $323.59	Professional	TC	$151.36	$218.78	$323.59