Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $151.36 / $446.68	Professional		$61.66	$151.36	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $66.07 / $141.25	Professional	26	$28.18	$66.07	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $66.07 / $151.36	Professional	TC	$39.81	$66.07	$151.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $181.97	Professional		$51.29	$51.29	$181.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $52.48 / $70.79	Professional	26	$15.85	$52.48	$70.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $35.48 / $35.48	Professional	TC	$35.48	$35.48	$35.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $158.49 / $162.18	Professional		$109.65	$158.49	$162.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $52.48 / $53.70	Professional	26	$35.48	$52.48	$53.70
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $102.33 / $107.15	Professional	TC	$72.44	$102.33	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $181.97 / $245.47	Professional		$66.07	$181.97	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $64.57 / $77.62	Professional	26	$34.67	$64.57	$77.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $117.49 / $165.96	Professional	TC	$43.65	$117.49	$165.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $186.21 / $229.09	Facility		$61.66	$186.21	$229.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $173.78 / $660.69	Professional		$81.28	$173.78	$660.69
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $61.66 / $81.28	Professional	26	$35.48	$61.66	$81.28
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $63.10 / $426.58	Professional	TC	$50.12	$63.10	$426.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $194.98 / $245.47	Professional		$165.96	$194.98	$245.47
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $64.57 / $81.28	Professional	26	$58.88	$64.57	$81.28
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $138.04 / $165.96	Professional	TC	$109.65	$138.04	$165.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $251.19 / $251.19	Professional		$223.87	$251.19	$251.19
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $77.62 / $81.28	Professional	26	$75.86	$77.62	$81.28
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $173.78 / $173.78	Professional	TC	$147.91	$173.78	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $100.00 / $199.53	Professional		$89.13	$100.00	$199.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $35.48 / $85.11	Professional	26	$31.62	$35.48	$85.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $63.10 / $128.82	Professional	TC	$50.12	$63.10	$128.82