Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $93.33 / $93.33	Facility	26	$93.33	$93.33	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $933.25 / $3,801.89	Professional		$776.25	$933.25	$3,801.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $100.00 / $380.19	Professional	26	$93.33	$100.00	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $691.83 / $794.33 / $4,786.30	Professional	TC	$691.83	$794.33	$4,786.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $186.21 / $186.21	Professional	26	$186.21	$186.21	$186.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,479.11 / $1,548.82	Professional		$1,380.38	$1,479.11	$1,548.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $177.83 / $186.21	Professional	26	$165.96	$177.83	$186.21
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,202.26 / $1,318.26 / $1,584.89	Professional	TC	$1,202.26	$1,318.26	$1,584.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $537.03 / $537.03 / $537.03	Facility	26	$537.03	$537.03	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,949.84 / $2,398.83	Professional		$1,513.56	$1,949.84	$2,398.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $223.87 / $281.84	Professional	26	$181.97	$223.87	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,348.96 / $1,698.24 / $2,137.96	Professional	TC	$1,348.96	$1,698.24	$2,137.96
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $436.52 / $436.52 / $436.52	Facility	26	$436.52	$436.52	$436.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,380.38 / $2,511.89	Professional		$1,023.29	$1,380.38	$2,511.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $158.49 / $288.40	Professional	26	$117.49	$158.49	$288.40
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $891.25 / $1,230.27 / $2,187.76	Professional	TC	$891.25	$1,230.27	$2,187.76
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,862.09 / $3,162.28	Professional		$1,548.82	$1,862.09	$3,162.28
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $213.80 / $363.08	Professional	26	$186.21	$213.80	$363.08
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $1,348.96 / $1,621.81 / $2,754.23	Professional	TC	$1,348.96	$1,621.81	$2,754.23
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $537.03 / $537.03 / $537.03	Facility	26	$537.03	$537.03	$537.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,905.46	Professional		$1,778.28	$1,778.28	$1,905.46
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $218.78 / $229.09	Professional	26	$218.78	$218.78	$229.09
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $1,548.82 / $1,548.82 / $1,659.59	Professional	TC	$1,548.82	$1,548.82	$1,659.59
United Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,584.89 / $2,238.72	Professional		$1,023.29	$1,584.89	$2,238.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $186.21 / $257.04	Professional	26	$117.49	$186.21	$257.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $891.25 / $1,380.38 / $1,995.26	Professional	TC	$891.25	$1,380.38	$1,995.26