Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $131.83 / $407.38	Facility	26	$95.50	$131.83	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $218.78 / $1,318.26	Professional		$194.98	$218.78	$1,318.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $173.78 / $1,071.52	Professional	TC	$151.36	$173.78	$1,071.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $371.54 / $389.05	Professional		$346.74	$371.54	$389.05
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $302.00 / $549.54	Professional	TC	$275.42	$302.00	$549.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $239.88 / $239.88 / $239.88	Facility	26	$239.88	$239.88	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $489.78 / $616.60	Professional		$389.05	$489.78	$616.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $389.05 / $489.78	Professional	TC	$302.00	$389.05	$489.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $199.53 / $199.53	Facility	26	$199.53	$199.53	$199.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $380.19 / $1,380.38	Professional		$251.19	$380.19	$1,380.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $302.00 / $1,174.90	Professional	TC	$199.53	$302.00	$1,174.90
Midlands Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $446.68 / $512.86	Professional		$389.05	$446.68	$512.86
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $95.50 / $107.15	Professional	26	$83.18	$95.50	$107.15
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $354.81 / $407.38	Professional	TC	$302.00	$354.81	$407.38
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $239.88 / $239.88 / $239.88	Facility	26	$239.88	$239.88	$239.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $478.63	Professional		$457.09	$457.09	$478.63
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $354.81 / $371.54	Professional	TC	$354.81	$354.81	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $389.05 / $549.54	Professional		$251.19	$389.05	$549.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $309.03 / $436.52	Professional	TC	$199.53	$309.03	$436.52