Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.86 / $371.86 / $1,044.92	Facility	26	$116.86	$371.86	$1,044.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $589.29 / $777.87 / $1,723.38	Professional		$589.29	$777.87	$1,723.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $116.86 / $142.54 / $548.62	Professional	26	$116.86	$142.54	$548.62
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $290.94 / $294.64 / $579.42	Professional	52	$290.94	$294.64	$579.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $472.44 / $614.16 / $991.78	Professional	TC	$472.44	$614.16	$991.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $104.51 / $207.88 / $273.80	Professional	26	$104.51	$207.88	$273.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $473.79 / $473.79 / $473.79	Professional	TC	$473.79	$473.79	$473.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $583.50 / $983.07 / $1,326.16	Professional		$583.50	$983.07	$1,326.16
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $115.70 / $189.27 / $262.99	Professional	26	$115.70	$189.27	$262.99
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $470.55 / $793.85 / $1,069.44	Professional	TC	$470.55	$793.85	$1,069.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,187.59 / $1,368.68 / $1,593.06	Professional		$1,187.59	$1,368.68	$1,593.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $233.71 / $260.11 / $317.39	Professional	26	$233.71	$260.11	$317.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $943.38 / $1,123.64 / $1,265.45	Professional	TC	$943.38	$1,123.64	$1,265.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $753.90 / $753.90 / $753.90	Facility	26	$753.90	$753.90	$753.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $950.11 / $1,291.61 / $6,200.00	Professional		$950.11	$1,291.61	$6,200.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $204.48 / $275.12 / $1,081.48	Professional	26	$204.48	$275.12	$1,081.48
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $775.32 / $1,023.66 / $3,875.48	Professional	TC	$775.32	$1,023.66	$3,875.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $952.79 / $1,293.05 / $1,678.99	Professional		$952.79	$1,293.05	$1,678.99
United Facility/Professional Professional Modifier Low / Median / High Price $979.80 / $1,318.28 / $1,546.32	Professional		$979.80	$1,318.28	$1,546.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $204.48 / $275.12 / $306.64	Professional	26	$204.48	$275.12	$306.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $775.32 / $1,043.16 / $1,239.68	Professional	TC	$775.32	$1,043.16	$1,239.68