Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $83.18 / $239.88	Facility	26	$48.98	$83.18	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $43.65 / $245.47	Professional		$34.67	$43.65	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $48.98 / $131.83	Professional	26	$22.91	$48.98	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $28.18 / $117.49	Professional	TC	$12.88	$28.18	$117.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $47.86 / $57.54	Professional	26	$23.44	$47.86	$57.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $70.79 / $75.86	Professional		$67.61	$70.79	$75.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $43.65 / $45.71	Professional	26	$41.69	$43.65	$45.71
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $28.84 / $85.11	Professional	TC	$26.30	$28.84	$85.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Facility	26	$131.83	$131.83	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $97.72 / $134.90	Professional		$74.13	$97.72	$134.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $56.23 / $72.44	Professional	26	$39.81	$56.23	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $40.74 / $77.62	Professional	TC	$28.84	$40.74	$77.62
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $120.23 / $120.23 / $120.23	Facility	26	$120.23	$120.23	$120.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $87.10 / $436.52	Professional		$53.70	$87.10	$436.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $39.81 / $338.84	Professional	26	$30.20	$39.81	$338.84
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $43.65 / $338.84	Professional	TC	$25.70	$43.65	$338.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $87.10 / $134.90	Professional		$75.86	$87.10	$134.90
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $51.29 / $81.28	Professional	26	$45.71	$51.29	$81.28
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $36.31 / $63.10	Professional	TC	$30.20	$36.31	$63.10
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Facility	26	$131.83	$131.83	$131.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $93.33	Professional		$91.20	$91.20	$93.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $54.95 / $56.23	Professional	26	$54.95	$54.95	$56.23
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $37.15 / $37.15	Professional	TC	$35.48	$37.15	$37.15
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $79.43 / $125.89	Professional		$53.70	$79.43	$125.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $43.65 / $60.26	Professional	26	$28.18	$43.65	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $31.62 / $58.88	Professional	TC	$25.70	$31.62	$58.88