Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $316.23 / $912.01	Facility	26	$223.87	$316.23	$912.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $295.12 / $758.58	Professional		$134.90	$295.12	$758.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $223.87 / $549.54	Professional	26	$102.33	$223.87	$549.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $41.69 / $234.42	Professional	TC	$28.84	$41.69	$234.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $117.49	Professional		$109.65	$109.65	$117.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $138.04 / $213.80	Professional	26	$104.71	$138.04	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $257.04 / $275.42	Professional		$245.47	$257.04	$275.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $194.98 / $208.93	Professional	26	$186.21	$194.98	$208.93
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $66.07 / $257.04	Professional	TC	$60.26	$66.07	$257.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $588.84 / $588.84 / $588.84	Facility	26	$588.84	$588.84	$588.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $338.84 / $478.63	Professional		$269.15	$338.84	$478.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $245.47 / $316.23	Professional	26	$154.88	$245.47	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $95.50 / $138.04	Professional	TC	$56.23	$95.50	$138.04
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $724.44 / $724.44 / $724.44	Facility	26	$724.44	$724.44	$724.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $269.15 / $3,019.95	Professional		$154.88	$269.15	$3,019.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $186.21 / $1,047.13	Professional	26	$123.03	$186.21	$1,047.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $61.66 / $2,511.89	Professional	TC	$28.18	$61.66	$2,511.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $302.00 / $478.63	Professional		$275.42	$302.00	$478.63
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $229.09 / $363.08	Professional	26	$208.93	$229.09	$363.08
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $66.07 / $102.33	Professional	TC	$56.23	$66.07	$102.33
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $588.84 / $588.84 / $588.84	Facility	26	$588.84	$588.84	$588.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $338.84	Professional		$331.13	$331.13	$338.84
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $245.47 / $245.47 / $251.19	Professional	26	$245.47	$245.47	$251.19
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $85.11 / $85.11	Professional	TC	$81.28	$85.11	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $275.42 / $389.05	Professional		$154.88	$275.42	$389.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $186.21 / $275.42	Professional	26	$123.03	$186.21	$275.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $58.88 / $154.88	Professional	TC	$28.18	$58.88	$154.88