Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $97.72 / $141.25	Professional		$40.74	$97.72	$141.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $38.90 / $69.18	Professional	26	$16.98	$38.90	$69.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.02 / $63.10	Professional	TC	$23.99	$38.02	$63.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $128.82	Professional		$30.90	$30.90	$128.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $12.59 / $61.66	Professional	26	$12.59	$12.59	$61.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $18.20 / $18.20	Professional	TC	$18.20	$18.20	$18.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Facility		$380.19	$380.19	$380.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $104.71	Professional		$69.18	$102.33	$104.71
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $41.69 / $42.66	Professional	26	$28.18	$41.69	$42.66
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $61.66 / $61.66	Professional	TC	$41.69	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $117.49 / $151.36	Professional		$91.20	$117.49	$151.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $51.29 / $61.66	Professional	26	$41.69	$51.29	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $64.57 / $91.20	Professional	TC	$42.66	$64.57	$91.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $154.88 / $295.12	Facility		$41.69	$154.88	$295.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $93.33 / $645.65	Professional		$58.88	$93.33	$645.65
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $51.29 / $79.43	Professional	26	$27.54	$51.29	$79.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $38.02 / $309.03	Professional	TC	$21.38	$38.02	$309.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $117.49 / $158.49	Professional		$109.65	$117.49	$158.49
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $51.29 / $64.57	Professional	26	$46.77	$51.29	$64.57
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $72.44 / $95.50	Professional	TC	$63.10	$72.44	$95.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $151.36 / $158.49	Professional		$147.91	$151.36	$158.49
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $61.66 / $64.57	Professional	26	$60.26	$61.66	$64.57
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $91.20 / $95.50	Professional	TC	$87.10	$91.20	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $63.10 / $169.82	Professional		$60.26	$63.10	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $28.18 / $79.43	Professional	26	$25.12	$28.18	$79.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $36.31 / $91.20	Professional	TC	$33.88	$36.31	$91.20