Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $131.83 / $398.11	Facility	26	$93.33	$131.83	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $69.18 / $398.11	Professional		$61.66	$69.18	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $75.86 / $398.11	Professional	26	$42.66	$75.86	$398.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $19.95 / $125.89	Professional	TC	$16.98	$19.95	$125.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $51.29 / $51.29	Professional	26	$51.29	$51.29	$51.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $117.49 / $125.89	Professional		$112.20	$117.49	$125.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $85.11 / $89.13	Professional	26	$79.43	$85.11	$89.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $35.48 / $125.89	Professional	TC	$33.11	$35.48	$125.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $257.04 / $257.04 / $257.04	Facility	26	$257.04	$257.04	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $147.91 / $194.98	Professional		$93.33	$147.91	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $107.15 / $134.90	Professional	26	$64.57	$107.15	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $42.66 / $57.54	Professional	TC	$27.54	$42.66	$57.54
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $208.93 / $208.93 / $208.93	Facility	26	$208.93	$208.93	$208.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $407.38	Professional		$72.44	$100.00	$407.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $407.38	Professional	26	$51.29	$72.44	$407.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $27.54 / $407.38	Professional	TC	$20.42	$27.54	$407.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $141.25 / $223.87	Professional		$125.89	$141.25	$223.87
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $100.00 / $158.49	Professional	26	$89.13	$100.00	$158.49
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $41.69 / $66.07	Professional	TC	$35.48	$41.69	$66.07
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $257.04 / $257.04 / $257.04	Facility	26	$257.04	$257.04	$257.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $154.88	Professional		$147.91	$147.91	$154.88
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $104.71 / $109.65	Professional	26	$104.71	$104.71	$109.65
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $42.66 / $43.65	Professional	TC	$42.66	$42.66	$43.65
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $102.33 / $162.18	Professional		$72.44	$102.33	$162.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $77.62 / $117.49	Professional	26	$51.29	$77.62	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $30.20 / $44.67	Professional	TC	$20.42	$30.20	$44.67