Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $85.11 / $123.03	Facility	26	$54.95	$85.11	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $89.13 / $199.53	Professional		$70.79	$89.13	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $48.98 / $154.88	Professional	26	$38.90	$48.98	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $41.69 / $81.28	Professional	TC	$20.89	$41.69	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $117.49 / $151.36	Professional		$70.79	$117.49	$151.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Professional	26	$72.44	$72.44	$72.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $117.49 / $162.18	Professional		$69.18	$117.49	$162.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $60.26 / $85.11	Professional	26	$37.15	$60.26	$85.11
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $56.23 / $77.62	Professional	TC	$34.67	$56.23	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $151.36 / $190.55	Professional		$81.28	$151.36	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $85.11 / $107.15	Professional	26	$50.12	$85.11	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $58.88 / $91.20	Professional	TC	$23.44	$58.88	$91.20
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $190.55 / $190.55	Facility	26	$95.50	$190.55	$190.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $131.83 / $616.60	Professional		$102.33	$131.83	$616.60
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $81.28 / $263.03	Professional	26	$67.61	$81.28	$263.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $50.12 / $263.03	Professional	TC	$32.36	$50.12	$263.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $144.54 / $186.21	Professional		$128.82	$144.54	$186.21
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $85.11 / $109.65	Professional	26	$77.62	$85.11	$109.65
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $48.98 / $89.13	Professional	TC	$45.71	$48.98	$89.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $177.83 / $186.21	Professional		$74.13	$177.83	$186.21
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $91.20 / $100.00	Professional	26	$53.70	$91.20	$100.00
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $83.18 / $89.13	Professional	TC	$21.88	$83.18	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $131.83 / $190.55	Professional		$102.33	$131.83	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $81.28 / $109.65	Professional	26	$64.57	$81.28	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $50.12 / $91.20	Professional	TC	$32.36	$50.12	$91.20