Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $549.54 / $575.44 / $575.44	Facility	26	$549.54	$575.44	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,698.24 / $4,897.79	Professional		$954.99	$1,698.24	$4,897.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $446.68 / $1,348.96	Professional	26	$128.82	$446.68	$1,348.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $691.83 / $1,202.26 / $1,819.70	Professional	TC	$691.83	$1,202.26	$1,819.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $257.04 / $354.81 / $537.03	Professional	26	$257.04	$354.81	$537.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,479.11 / $2,041.74	Professional		$912.01	$1,479.11	$2,041.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $245.47 / $407.38 / $562.34	Professional	26	$245.47	$407.38	$562.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $660.69 / $1,096.48 / $1,584.89	Professional	TC	$660.69	$1,096.48	$1,584.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $2,137.96 / $2,630.27	Professional		$1,174.90	$2,137.96	$2,630.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $363.08 / $562.34 / $741.31	Professional	26	$363.08	$562.34	$741.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $812.83 / $1,548.82 / $1,949.84	Professional	TC	$812.83	$1,548.82	$1,949.84
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $2,630.27 / $2,630.27 / $2,630.27	Facility	26	$2,630.27	$2,630.27	$2,630.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,995.26 / $2,818.38	Professional		$1,288.25	$1,995.26	$2,818.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $389.05 / $602.56 / $831.76	Professional	26	$389.05	$602.56	$831.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $1,000.00 / $1,445.44 / $1,995.26	Professional	TC	$1,000.00	$1,445.44	$1,995.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,290.87 / $2,570.40	Professional		$1,949.84	$2,290.87	$2,570.40
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $562.34 / $616.60 / $741.31	Professional	26	$562.34	$616.60	$741.31
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $1,380.38 / $1,698.24 / $1,819.70	Professional	TC	$1,380.38	$1,698.24	$1,819.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $2,187.76 / $2,187.76	Professional		$2,187.76	$2,187.76	$2,187.76
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $602.56 / $602.56 / $602.56	Professional	26	$602.56	$602.56	$602.56
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Professional	TC	$1,584.89	$1,584.89	$1,584.89
United Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $2,089.30 / $2,630.27	Professional		$1,380.38	$2,089.30	$2,630.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $389.05 / $575.44 / $724.44	Professional	26	$389.05	$575.44	$724.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,000.00 / $1,445.44 / $1,905.46	Professional	TC	$1,000.00	$1,445.44	$1,905.46