Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $123.03 / $363.08	Facility	26	$50.12	$123.03	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $562.34 / $1,479.11	Professional		$257.04	$562.34	$1,479.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $93.33 / $213.80	Professional	26	$38.02	$93.33	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $281.84 / $1,258.93	Professional	TC	$218.78	$281.84	$1,258.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $245.47 / $602.56	Professional		$194.98	$245.47	$602.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $56.23 / $85.11	Professional	26	$30.20	$56.23	$85.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $407.38 / $407.38	Professional	TC	$407.38	$407.38	$407.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $478.63 / $512.86	Professional		$457.09	$478.63	$512.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $72.44 / $77.62	Professional	26	$69.18	$72.44	$77.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $416.87 / $446.68	Professional	TC	$380.19	$416.87	$446.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	26	$223.87	$223.87	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $630.96 / $794.33	Professional		$501.19	$630.96	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $93.33 / $114.82	Professional	26	$75.86	$93.33	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $549.54 / $676.08	Professional	TC	$426.58	$549.54	$676.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	26	$223.87	$223.87	$223.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $426.58 / $1,819.70	Professional		$257.04	$426.58	$1,819.70
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $72.44 / $331.13	Professional	26	$50.12	$72.44	$331.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $389.05 / $1,548.82	Professional	TC	$288.40	$389.05	$1,548.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $602.56 / $676.08	Professional		$512.86	$602.56	$676.08
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $87.10 / $97.72	Professional	26	$77.62	$87.10	$97.72
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $512.86 / $588.84	Professional	TC	$426.58	$512.86	$588.84
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	26	$223.87	$223.87	$223.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $588.84 / $616.60	Professional		$588.84	$588.84	$616.60
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $89.13 / $95.50	Professional	26	$89.13	$89.13	$95.50
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $501.19 / $524.81	Professional	TC	$501.19	$501.19	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $512.86 / $707.95	Professional		$263.03	$512.86	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $77.62 / $107.15	Professional	26	$50.12	$77.62	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $436.52 / $602.56	Professional	TC	$229.09	$436.52	$602.56