Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $114.82 / $169.82	Facility	26	$74.13	$114.82	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $114.82 / $380.19	Professional		$87.10	$114.82	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $223.87	Professional	26	$52.48	$72.44	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $46.77 / $89.13	Professional	TC	$25.12	$46.77	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $134.90 / $229.09	Professional		$87.10	$134.90	$229.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $123.03 / $131.83	Professional	26	$104.71	$123.03	$131.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $144.54 / $199.53	Professional		$85.11	$144.54	$199.53
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $83.18 / $114.82	Professional	26	$50.12	$83.18	$114.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $61.66 / $85.11	Professional	TC	$38.02	$61.66	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $186.21 / $229.09	Professional		$102.33	$186.21	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $117.49 / $144.54	Professional	26	$67.61	$117.49	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $64.57 / $97.72	Professional	TC	$26.92	$64.57	$97.72
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $245.47 / $245.47	Facility	26	$128.82	$245.47	$245.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $165.96 / $741.31	Professional		$125.89	$165.96	$741.31
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $112.20 / $354.81	Professional	26	$87.10	$112.20	$354.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $54.95 / $288.40	Professional	TC	$37.15	$54.95	$288.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $186.21 / $229.09	Professional		$165.96	$186.21	$229.09
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $114.82 / $151.36	Professional	26	$104.71	$114.82	$151.36
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $56.23 / $97.72	Professional	TC	$48.98	$56.23	$97.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $218.78 / $229.09	Professional		$95.50	$218.78	$229.09
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $125.89 / $138.04	Professional	26	$72.44	$125.89	$138.04
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $91.20 / $97.72	Professional	TC	$23.99	$91.20	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $169.82 / $234.42	Professional		$125.89	$169.82	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $112.20 / $147.91	Professional	26	$87.10	$112.20	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $54.95 / $100.00	Professional	TC	$37.15	$54.95	$100.00