Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.55 / $370.97 / $1,006.19	Facility	26	$112.55	$370.97	$1,006.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $563.67 / $720.28 / $1,108.39	Professional		$563.67	$720.28	$1,108.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.55 / $144.08 / $524.60	Professional	26	$112.55	$144.08	$524.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $277.07 / $281.83 / $554.20	Professional	52	$277.07	$281.83	$554.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $451.13 / $586.46 / $912.73	Professional	TC	$451.13	$586.46	$912.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $199.89 / $199.89 / $263.27	Professional	26	$199.89	$199.89	$263.27
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $451.84 / $451.84 / $451.84	Professional	TC	$451.84	$451.84	$451.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $558.13 / $940.71 / $1,268.51	Professional		$558.13	$940.71	$1,268.51
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $111.44 / $182.13 / $253.28	Professional	26	$111.44	$182.13	$253.28
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $449.68 / $758.63 / $1,021.99	Professional	TC	$449.68	$758.63	$1,021.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,132.91 / $1,306.91 / $1,519.71	Professional		$1,132.91	$1,306.91	$1,519.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $224.91 / $250.75 / $305.62	Professional	26	$224.91	$250.75	$305.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $897.75 / $1,071.47 / $1,204.24	Professional	TC	$897.75	$1,071.47	$1,204.24
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $701.13 / $701.13 / $701.13	Facility	26	$701.13	$701.13	$701.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $909.17 / $1,231.41 / $6,200.00	Professional		$909.17	$1,231.41	$6,200.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $196.91 / $264.93 / $2,600.00	Professional	26	$196.91	$264.93	$2,600.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $740.67 / $973.62 / $7,000.00	Professional	TC	$740.67	$973.62	$7,000.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $907.33 / $1,218.94 / $1,543.44	Professional		$907.33	$1,218.94	$1,543.44
United Facility/Professional Professional Modifier Low / Median / High Price $937.58 / $1,261.47 / $1,434.10	Professional		$937.58	$1,261.47	$1,434.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $196.91 / $272.95 / $295.33	Professional	26	$196.91	$272.95	$295.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $740.67 / $1,010.00 / $1,183.77	Professional	TC	$740.67	$1,010.00	$1,183.77