Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $72.44 / $208.93	Facility	26	$47.86	$72.44	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $275.42 / $1,412.54	Professional		$204.17	$275.42	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $52.48 / $134.90	Professional	26	$21.88	$52.48	$134.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $223.87 / $1,258.93	Professional	TC	$181.97	$223.87	$1,258.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $26.30 / $44.67	Professional	26	$17.38	$26.30	$44.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $309.03 / $309.03	Professional	TC	$309.03	$309.03	$309.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $389.05 / $407.38	Professional		$363.08	$389.05	$407.38
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $42.66 / $44.67	Professional	26	$39.81	$42.66	$44.67
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $354.81 / $416.87	Professional	TC	$316.23	$354.81	$416.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	26	$128.82	$128.82	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $512.86 / $645.65	Professional		$407.38	$512.86	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $53.70 / $67.61	Professional	26	$43.65	$53.70	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $467.74 / $575.44	Professional	TC	$363.08	$467.74	$575.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $104.71 / $104.71	Facility	26	$104.71	$104.71	$104.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $363.08 / $630.96	Professional		$269.15	$363.08	$630.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.02 / $69.18	Professional	26	$28.18	$38.02	$69.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $323.59 / $562.34	Professional	TC	$239.88	$323.59	$562.34
Midlands Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $478.63 / $549.54	Professional		$407.38	$478.63	$549.54
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $51.29 / $57.54	Professional	26	$44.67	$51.29	$57.54
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $426.58 / $489.78	Professional	TC	$363.08	$426.58	$489.78
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	26	$128.82	$128.82	$128.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $501.19	Professional		$478.63	$478.63	$501.19
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $52.48 / $54.95	Professional	26	$52.48	$52.48	$54.95
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $426.58 / $446.68	Professional	TC	$426.58	$426.58	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $416.87 / $588.84	Professional		$269.15	$416.87	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $44.67 / $61.66	Professional	26	$28.18	$44.67	$61.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $371.54 / $524.81	Professional	TC	$239.88	$371.54	$524.81