Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $38.02 / $38.90	Facility	26	$37.15	$38.02	$38.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $85.11 / $281.84	Professional		$54.95	$85.11	$281.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $22.91 / $77.62	Professional	26	$16.60	$22.91	$77.62
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $199.53 / $199.53 / $199.53	Professional	50	$199.53	$199.53	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $46.77 / $95.50	Professional	TC	$38.02	$46.77	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $69.18 / $123.03	Professional		$58.88	$69.18	$123.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $21.88 / $33.88	Professional	26	$15.85	$21.88	$33.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $93.33 / $125.89	Professional		$56.23	$93.33	$125.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $28.18 / $38.02	Professional	26	$16.60	$28.18	$38.02
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $64.57 / $89.13	Professional	TC	$38.90	$64.57	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $120.23 / $162.18	Professional		$60.26	$120.23	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $37.15 / $47.86	Professional	26	$20.42	$37.15	$47.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $85.11 / $114.82	Professional	TC	$40.74	$85.11	$114.82
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $81.28 / $81.28	Facility	26	$81.28	$81.28	$81.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $114.82 / $416.87	Professional		$91.20	$114.82	$416.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $36.31 / $114.82	Professional	26	$29.51	$36.31	$114.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $77.62 / $302.00	Professional	TC	$60.26	$77.62	$302.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $128.82 / $151.36	Professional		$117.49	$128.82	$151.36
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $38.90 / $48.98	Professional	26	$36.31	$38.90	$48.98
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $87.10 / $102.33	Professional	TC	$79.43	$87.10	$102.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $134.90 / $144.54	Professional		$72.44	$134.90	$144.54
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $40.74 / $43.65	Professional	26	$23.44	$40.74	$43.65
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $93.33 / $100.00	Professional	TC	$48.98	$93.33	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $112.20 / $151.36	Professional		$79.43	$112.20	$151.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $35.48 / $45.71	Professional	26	$23.99	$35.48	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $77.62 / $107.15	Professional	TC	$56.23	$77.62	$107.15