Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $95.50 / $95.50	Facility	26	$91.20	$95.50	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $177.83 / $436.52	Professional		$85.11	$177.83	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $64.57 / $213.80	Professional	26	$41.69	$64.57	$213.80
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $85.11 / $323.59 / $389.05	Professional	50	$85.11	$323.59	$389.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $54.95 / $114.82	Professional	TC	$39.81	$54.95	$114.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $97.72 / $194.98	Professional		$79.43	$97.72	$194.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $67.61 / $104.71	Professional	26	$38.02	$67.61	$104.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $144.54 / $199.53	Professional		$87.10	$144.54	$199.53
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $67.61 / $93.33	Professional	26	$40.74	$67.61	$93.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $77.62 / $104.71	Professional	TC	$46.77	$77.62	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $190.55 / $257.04	Professional		$95.50	$190.55	$257.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $91.20 / $117.49	Professional	26	$50.12	$91.20	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $100.00 / $134.90	Professional	TC	$47.86	$100.00	$134.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $199.53 / $199.53	Facility	26	$199.53	$199.53	$199.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $181.97 / $645.65	Professional		$144.54	$181.97	$645.65
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $91.20 / $281.84	Professional	26	$72.44	$91.20	$281.84
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $89.13 / $354.81	Professional	TC	$64.57	$89.13	$354.81
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $204.17 / $239.88	Professional		$181.97	$204.17	$239.88
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $95.50 / $120.23	Professional	26	$89.13	$95.50	$120.23
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $104.71 / $120.23	Professional	TC	$91.20	$104.71	$120.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $208.93 / $223.87	Professional		$112.20	$208.93	$223.87
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $100.00 / $104.71	Professional	26	$57.54	$100.00	$104.71
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $109.65 / $120.23	Professional	TC	$54.95	$109.65	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $177.83 / $239.88	Professional		$125.89	$177.83	$239.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $87.10 / $112.20	Professional	26	$61.66	$87.10	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $89.13 / $123.03	Professional	TC	$60.26	$89.13	$123.03