Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $147.91 / $467.74	Professional		$72.44	$147.91	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $87.10 / $331.13	Professional	26	$33.88	$87.10	$331.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $74.13 / $123.03	Professional	TC	$46.77	$74.13	$123.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $19.50 / $91.20	Professional	26	$18.62	$19.50	$91.20
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 $123.03 / $181.97 / $181.97	Professional		$123.03	$181.97	$181.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $63.10 / $63.10	Professional	26	$42.66	$63.10	$63.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $120.23 / $120.23	Professional	TC	$81.28	$120.23	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $218.78 / $269.15	Professional		$81.28	$218.78	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $77.62 / $91.20	Professional	26	$44.67	$77.62	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $141.25 / $177.83	Professional	TC	$40.74	$141.25	$177.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $223.87 / $288.40	Facility		$72.44	$223.87	$288.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $128.82 / $758.58	Professional		$107.15	$128.82	$758.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $72.44 / $151.36	Professional	26	$39.81	$72.44	$151.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $75.86 / $512.86	Professional	TC	$45.71	$75.86	$512.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $218.78 / $281.84	Professional		$199.53	$218.78	$281.84
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $77.62 / $97.72	Professional	26	$69.18	$77.62	$97.72
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $141.25 / $186.21	Professional	TC	$128.82	$141.25	$186.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $281.84	Professional		$269.15	$269.15	$281.84
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $91.20 / $97.72	Professional	26	$91.20	$91.20	$97.72
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $173.78 / $186.21	Professional	TC	$173.78	$173.78	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $117.49 / $234.42	Professional		$104.71	$117.49	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $43.65 / $109.65	Professional	26	$38.02	$43.65	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $75.86 / $151.36	Professional	TC	$57.54	$75.86	$151.36