Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $186.21 / $549.54	Facility	26	$125.89	$186.21	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $257.04 / $1,479.11	Professional		$117.49	$257.04	$1,479.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $173.78 / $891.25	Professional	26	$57.54	$173.78	$891.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $109.65 / $389.05	Professional	TC	$58.88	$109.65	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $100.00 / $229.09	Professional		$95.50	$100.00	$229.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $69.18 / $144.54	Professional	26	$48.98	$69.18	$144.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $91.20 / $91.20	Professional	TC	$91.20	$91.20	$91.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $229.09 / $239.88	Professional		$213.80	$229.09	$239.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $112.20 / $117.49	Professional	26	$104.71	$112.20	$117.49
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $120.23 / $309.03	Professional	TC	$109.65	$120.23	$309.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $338.84 / $338.84 / $338.84	Facility	26	$338.84	$338.84	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $288.40 / $389.05	Professional		$223.87	$288.40	$389.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $141.25 / $177.83	Professional	26	$91.20	$141.25	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $151.36 / $223.87	Professional	TC	$120.23	$151.36	$223.87
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	26	$346.74	$346.74	$346.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $234.42 / $398.11	Professional		$158.49	$234.42	$398.11
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $112.20 / $177.83	Professional	26	$74.13	$112.20	$177.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $120.23 / $724.44	Professional	TC	$74.13	$120.23	$724.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $269.15 / $426.58	Professional		$239.88	$269.15	$426.58
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $131.83 / $204.17	Professional	26	$117.49	$131.83	$204.17
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $141.25 / $223.87	Professional	TC	$123.03	$141.25	$223.87
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $338.84 / $338.84 / $338.84	Facility	26	$338.84	$338.84	$338.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $281.84 / $295.12	Professional		$281.84	$281.84	$295.12
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $138.04 / $144.54	Professional	26	$138.04	$138.04	$144.54
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $147.91 / $151.36	Professional	TC	$147.91	$147.91	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $234.42 / $316.23	Professional		$144.54	$234.42	$316.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $109.65 / $154.88	Professional	26	$72.44	$109.65	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $120.23 / $158.49	Professional	TC	$74.13	$120.23	$158.49