Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.58 / $58.58 / $58.58	Facility		$58.58	$58.58	$58.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $25.70 / $25.70	Facility	26	$25.70	$25.70	$25.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.84 / $62.80 / $143.97	Professional		$54.84	$62.80	$143.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.87 / $26.87 / $65.48	Professional	26	$22.87	$26.87	$65.48
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.14 / $29.29 / $43.93	Professional	52	$26.14	$29.29	$43.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.05 / $32.89 / $49.26	Professional	TC	$29.05	$32.89	$49.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.91 / $138.91 / $138.91	Professional		$138.91	$138.91	$138.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.91 / $59.89 / $59.89	Professional	26	$50.91	$59.89	$59.89
BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.19 / $131.19 / $131.19	Facility		$131.19	$131.19	$131.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $95.76 / $135.56	Professional		$59.64	$95.76	$135.56
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.57 / $41.07 / $58.14	Professional	26	$25.57	$41.07	$58.14
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.57 / $54.70 / $76.29	Professional	TC	$33.57	$54.70	$76.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.35 / $121.54 / $160.65	Professional		$50.35	$121.54	$160.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.05 / $54.03 / $72.47	Professional	26	$22.05	$54.03	$72.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.37 / $71.09 / $88.18	Professional	TC	$28.37	$71.09	$88.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $50.62 / $90.45 / $137.94	Facility		$50.62	$90.45	$137.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.58 / $114.84 / $173.23	Professional		$57.58	$114.84	$173.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.34 / $43.20 / $167.21	Professional	26	$25.34	$43.20	$167.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $33.69 / $52.13 / $257.11	Professional	TC	$33.69	$52.13	$257.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $119.50 / $132.58 / $160.65	Facility		$119.50	$132.58	$160.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $95.14 / $126.76 / $160.65	Professional		$95.14	$126.76	$160.65
United Facility/Professional Professional Modifier Low / Median / High Price $56.61 / $95.33 / $146.15	Professional		$56.61	$95.33	$146.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.93 / $43.20 / $66.23	Professional	26	$23.93	$43.20	$66.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.06 / $70.73 / $81.73	Professional	TC	$33.06	$70.73	$81.73