Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $204.17 / $263.03 / $954.99	Facility	26	$204.17	$263.03	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $812.83 / $1,548.82	Professional		$588.84	$812.83	$1,548.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $199.53 / $562.34	Professional	26	$117.49	$199.53	$562.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $660.69 / $1,174.90	Professional	TC	$467.74	$660.69	$1,174.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $630.96	Professional		$467.74	$467.74	$630.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $144.54 / $245.47	Professional	26	$109.65	$144.54	$245.47
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $467.74 / $478.63	Professional	TC	$323.59	$467.74	$478.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $954.99 / $1,318.26	Professional		$588.84	$954.99	$1,318.26
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $186.21 / $257.04	Professional	26	$112.20	$186.21	$257.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $776.25 / $1,071.52	Professional	TC	$467.74	$776.25	$1,071.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,258.93 / $1,698.24	Professional		$676.08	$1,258.93	$1,698.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $251.19 / $309.03	Professional	26	$138.04	$251.19	$309.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $1,023.29 / $1,412.54	Professional	TC	$537.03	$1,023.29	$1,412.54
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $758.58 / $758.58 / $758.58	Facility	26	$758.58	$758.58	$758.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,318.26 / $6,165.95	Professional		$954.99	$1,318.26	$6,165.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $281.84 / $1,071.52	Professional	26	$199.53	$281.84	$1,071.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $758.58 / $1,047.13 / $3,890.45	Professional	TC	$758.58	$1,047.13	$3,890.45
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,348.96 / $1,584.89	Professional		$1,230.27	$1,348.96	$1,584.89
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $245.47 / $263.03 / $331.13	Professional	26	$245.47	$263.03	$331.13
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $977.24 / $1,096.48 / $1,258.93	Professional	TC	$977.24	$1,096.48	$1,258.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,445.44 / $1,513.56	Professional		$794.33	$1,445.44	$1,513.56
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $275.42 / $288.40	Professional	26	$158.49	$275.42	$288.40
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $630.96 / $1,174.90 / $1,230.27	Professional	TC	$630.96	$1,174.90	$1,230.27
United Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,288.25 / $1,548.82	Professional		$851.14	$1,288.25	$1,548.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $269.15 / $331.13	Professional	26	$169.82	$269.15	$331.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $691.83 / $977.24 / $1,230.27	Professional	TC	$691.83	$977.24	$1,230.27