Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.78 / $138.57 / $503.94	Facility	26	$41.78	$138.57	$503.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.21 / $185.43 / $380.68	Professional		$86.21	$185.43	$380.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.78 / $59.07 / $147.36	Professional	26	$41.78	$59.07	$147.36
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $43.11 / $57.83 / $188.67	Professional	52	$43.11	$57.83	$188.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.43 / $117.78 / $151.63	Professional	TC	$44.43	$117.78	$151.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.93 / $86.93 / $211.81	Professional		$86.93	$86.93	$211.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.50 / $63.50 / $97.88	Professional	26	$63.50	$63.50	$97.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $46.77 / $46.77	Professional	TC	$46.77	$46.77	$46.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.50 / $144.25 / $194.33	Professional		$85.50	$144.25	$194.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.36 / $67.81 / $94.01	Professional	26	$41.36	$67.81	$94.01
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.31 / $76.45 / $102.98	Professional	TC	$45.31	$76.45	$102.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $185.62 / $221.44 / $256.80	Professional		$185.62	$221.44	$256.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.76 / $95.72 / $119.69	Professional	26	$83.76	$95.72	$119.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.36 / $117.35 / $161.08	Professional	TC	$98.36	$117.35	$161.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $97.37 / $333.99 / $333.99	Facility	26	$97.37	$333.99	$333.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $182.16 / $245.09 / $3,000.00	Professional		$182.16	$245.09	$3,000.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $73.19 / $108.82 / $870.13	Professional	26	$73.19	$108.82	$870.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $108.97 / $146.61 / $870.13	Professional	TC	$108.97	$146.61	$870.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $194.54 / $252.42 / $354.00	Professional		$194.54	$252.42	$354.00
United Facility/Professional Professional Modifier Low / Median / High Price $176.64 / $215.28 / $312.27	Professional		$176.64	$215.28	$312.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.19 / $99.65 / $130.27	Professional	26	$73.19	$99.65	$130.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $105.96 / $128.78 / $216.50	Professional	TC	$105.96	$128.78	$216.50