Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $141.25 / $416.87	Facility	26	$93.33	$141.25	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $281.84 / $1,348.96	Professional		$199.53	$281.84	$1,348.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $102.33 / $245.47	Professional	26	$42.66	$102.33	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $177.83 / $1,071.52	Professional	TC	$154.88	$177.83	$1,071.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $34.67 / $57.54	Professional	26	$34.67	$34.67	$57.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $380.19 / $398.11	Professional		$354.81	$380.19	$398.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $83.18 / $89.13	Professional	26	$79.43	$83.18	$89.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $302.00 / $416.87	Professional	TC	$275.42	$302.00	$416.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $257.04 / $257.04 / $257.04	Facility	26	$257.04	$257.04	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $501.19 / $616.60	Professional		$398.11	$501.19	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $104.71 / $131.83	Professional	26	$87.10	$104.71	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $389.05 / $489.78	Professional	TC	$309.03	$389.05	$489.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $208.93 / $208.93 / $208.93	Facility	26	$208.93	$208.93	$208.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $389.05 / $1,479.11	Professional		$257.04	$389.05	$1,479.11
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $83.18 / $501.19	Professional	26	$56.23	$83.18	$501.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $302.00 / $1,230.27	Professional	TC	$199.53	$302.00	$1,230.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $457.09 / $512.86	Professional		$398.11	$457.09	$512.86
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $102.33 / $112.20	Professional	26	$89.13	$102.33	$112.20
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $363.08 / $407.38	Professional	TC	$309.03	$363.08	$407.38
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $257.04 / $257.04 / $257.04	Facility	26	$257.04	$257.04	$257.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $489.78	Professional		$457.09	$457.09	$489.78
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $102.33 / $109.65	Professional	26	$102.33	$102.33	$109.65
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $354.81 / $380.19	Professional	TC	$354.81	$354.81	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $398.11 / $562.34	Professional		$257.04	$398.11	$562.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $89.13 / $123.03	Professional	26	$56.23	$89.13	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $309.03 / $436.52	Professional	TC	$199.53	$309.03	$436.52