Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $173.78 / $512.86	Facility	26	$117.49	$173.78	$512.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $467.74 / $977.24	Professional		$389.05	$467.74	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $75.86 / $138.04	Professional	26	$53.70	$75.86	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $407.38 / $851.14	Professional	TC	$331.13	$407.38	$851.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $100.00 / $125.89	Professional	26	$56.23	$100.00	$125.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $229.09 / $229.09	Professional	TC	$229.09	$229.09	$229.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $645.65 / $870.96	Professional		$389.05	$645.65	$870.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $87.10 / $117.49	Professional	26	$52.48	$87.10	$117.49
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $549.54 / $758.58	Professional	TC	$331.13	$549.54	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $831.76 / $1,148.15	Professional		$436.52	$831.76	$1,148.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $117.49 / $141.25	Professional	26	$63.10	$117.49	$141.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $724.44 / $1,000.00	Professional	TC	$371.54	$724.44	$1,000.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $416.87 / $416.87 / $416.87	Facility	26	$416.87	$416.87	$416.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $776.25 / $3,890.45	Professional		$588.84	$776.25	$3,890.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $128.82 / $616.60	Professional	26	$93.33	$128.82	$616.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $660.69 / $3,548.13	Professional	TC	$489.78	$660.69	$3,548.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $891.25 / $1,047.13	Professional		$794.33	$891.25	$1,047.13
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $120.23 / $154.88	Professional	26	$114.82	$120.23	$154.88
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $676.08 / $776.25 / $891.25	Professional	TC	$676.08	$776.25	$891.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $977.24 / $1,000.00	Professional		$524.81	$977.24	$1,000.00
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $128.82 / $134.90	Professional	26	$74.13	$128.82	$134.90
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $851.14 / $851.14	Professional	TC	$446.68	$851.14	$851.14
United Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $741.31 / $1,000.00	Professional		$549.54	$741.31	$1,000.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $125.89 / $165.96	Professional	26	$79.43	$125.89	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $645.65 / $851.14	Professional	TC	$489.78	$645.65	$851.14