Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $467.74 / $645.65 / $1,905.46	Facility	26	$467.74	$645.65	$1,905.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $537.03 / $2,754.23	Professional		$436.52	$537.03	$2,754.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $213.80 / $467.74 / $1,047.13	Professional	26	$213.80	$467.74	$1,047.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $269.15 / $1,479.11	Professional	TC	$218.78	$269.15	$1,479.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $380.19 / $1,122.02	Professional		$354.81	$380.19	$1,122.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $269.15 / $457.09	Professional	26	$181.97	$269.15	$457.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $851.14 / $891.25	Professional		$794.33	$851.14	$891.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $389.05 / $416.87 / $436.52	Professional	26	$389.05	$416.87	$436.52
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $436.52 / $707.95	Professional	TC	$354.81	$436.52	$707.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Facility	26	$1,258.93	$1,258.93	$1,258.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,096.48 / $1,412.54	Professional		$691.83	$1,096.48	$1,412.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $323.59 / $524.81 / $676.08	Professional	26	$323.59	$524.81	$676.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $562.34 / $758.58	Professional	TC	$363.08	$562.34	$758.58
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $478.63 / $1,023.29 / $1,023.29	Facility	26	$478.63	$1,023.29	$1,023.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $831.76 / $1,348.96	Professional		$549.54	$831.76	$1,348.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $269.15 / $416.87 / $616.60	Professional	26	$269.15	$416.87	$616.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $354.81 / $1,479.11	Professional	TC	$281.84	$354.81	$1,479.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,023.29 / $1,621.81	Professional		$891.25	$1,023.29	$1,621.81
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $436.52 / $489.78 / $776.25	Professional	26	$436.52	$489.78	$776.25
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $524.81 / $831.76	Professional	TC	$457.09	$524.81	$831.76
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Facility	26	$1,258.93	$1,258.93	$1,258.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,096.48	Professional		$1,071.52	$1,071.52	$1,096.48
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $512.86 / $512.86 / $537.03	Professional	26	$512.86	$512.86	$537.03
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $549.54 / $549.54 / $562.34	Professional	TC	$549.54	$549.54	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $831.76 / $1,202.26	Professional		$549.54	$831.76	$1,202.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $269.15 / $380.19 / $575.44	Professional	26	$269.15	$380.19	$575.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $436.52 / $616.60	Professional	TC	$281.84	$436.52	$616.60