Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.88 / $485.00 / $751.06	Facility		$138.88	$485.00	$751.06
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.45 / $158.22 / $429.20	Facility	26	$38.45	$158.22	$429.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.88 / $211.81 / $401.52	Professional		$138.88	$211.81	$401.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.45 / $55.46 / $210.38	Professional	26	$38.45	$55.46	$210.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.42 / $146.08 / $279.72	Professional	TC	$100.42	$146.08	$279.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.49 / $115.49 / $115.49	Professional		$115.49	$115.49	$115.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.95 / $56.60 / $66.23	Professional	26	$39.95	$56.60	$66.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $79.69 / $79.69 / $79.69	Professional	TC	$79.69	$79.69	$79.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $320.51 / $414.74 / $650.13	Facility		$320.51	$414.74	$650.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.33 / $208.63 / $289.38	Professional		$127.33	$208.63	$289.38
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.57 / $60.93 / $85.39	Professional	26	$37.57	$60.93	$85.39
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.75 / $147.05 / $203.96	Professional	TC	$89.75	$147.05	$203.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.05 / $314.01 / $408.08	Professional		$255.05	$314.01	$408.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.27 / $86.49 / $109.47	Professional	26	$75.27	$86.49	$109.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.80 / $232.40 / $302.02	Professional	TC	$179.80	$232.40	$302.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $140.90 / $256.93 / $519.98	Facility		$140.90	$256.93	$519.98
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $174.10 / $174.10 / $174.10	Facility	26	$174.10	$174.10	$174.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $256.43 / $347.65 / $1,023.12	Professional		$256.43	$347.65	$1,023.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.09 / $92.01 / $261.30	Professional	26	$67.09	$92.01	$261.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $189.07 / $249.11 / $767.60	Professional	TC	$189.07	$249.11	$767.60
Midlands Facility/Professional Facility Modifier Low / Median / High Price $255.05 / $329.53 / $421.23	Facility		$255.05	$329.53	$421.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $255.05 / $321.86 / $421.23	Professional		$255.05	$321.86	$421.23
United Facility/Professional Professional Modifier Low / Median / High Price $256.43 / $345.01 / $381.22	Professional		$256.43	$345.01	$381.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.36 / $91.70 / $109.56	Professional	26	$67.36	$91.70	$109.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $189.07 / $252.08 / $281.08	Professional	TC	$189.07	$252.08	$281.08