Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $15.85 / $19.50	Facility	26	$10.47	$15.85	$19.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $64.57 / $288.40	Professional		$52.48	$64.57	$288.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.12 / $35.48	Professional	26	$7.94	$9.12	$35.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $50.12 / $104.71	Professional	TC	$43.65	$50.12	$104.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $66.07 / $120.23	Professional		$48.98	$66.07	$120.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $11.22 / $16.60	Professional	26	$7.59	$11.22	$16.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $72.44 / $72.44	Professional	TC	$72.44	$72.44	$72.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $83.18 / $114.82	Professional		$50.12	$83.18	$114.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.18 / $18.20	Professional	26	$7.94	$13.18	$18.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $69.18 / $97.72	Professional	TC	$42.66	$69.18	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $107.15 / $151.36	Professional		$63.10	$107.15	$151.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $17.78 / $23.44	Professional	26	$9.77	$17.78	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $89.13 / $128.82	Professional	TC	$53.70	$89.13	$128.82
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $79.43 / $79.43	Facility	26	$20.42	$79.43	$79.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $114.82 / $371.54	Professional		$77.62	$114.82	$371.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $18.20 / $54.95	Professional	26	$13.80	$18.20	$54.95
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $89.13 / $316.23	Professional	TC	$57.54	$89.13	$316.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $123.03 / $134.90	Professional		$104.71	$123.03	$134.90
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $18.62 / $21.88	Professional	26	$16.60	$18.62	$21.88
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $102.33 / $114.82	Professional	TC	$85.11	$102.33	$114.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $93.33 / $131.83	Professional		$66.07	$93.33	$131.83
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $16.22 / $20.89	Professional	26	$11.22	$16.22	$20.89
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $75.86 / $109.65	Professional	TC	$54.95	$75.86	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $93.33 / $131.83	Professional		$57.54	$93.33	$131.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.85 / $21.38	Professional	26	$9.33	$15.85	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $77.62 / $109.65	Professional	TC	$47.86	$77.62	$109.65