Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $380.19 / $389.05 / $398.11	Facility	26	$380.19	$389.05	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $380.19 / $676.08	Professional		$269.15	$380.19	$676.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $229.09 / $436.52	Professional	26	$169.82	$229.09	$436.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $120.23 / $229.09	Professional	TC	$93.33	$120.23	$229.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $323.59 / $707.95	Professional		$186.21	$323.59	$707.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $295.12 / $331.13 / $446.68	Professional	26	$295.12	$331.13	$446.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $436.52 / $588.84	Professional		$257.04	$436.52	$588.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $281.84 / $380.19	Professional	26	$169.82	$281.84	$380.19
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $151.36 / $208.93	Professional	TC	$91.20	$151.36	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $588.84 / $758.58	Professional		$309.03	$588.84	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $380.19 / $489.78	Professional	26	$204.17	$380.19	$489.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $213.80 / $275.42	Professional	TC	$109.65	$213.80	$275.42
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $831.76 / $831.76 / $831.76	Facility	26	$831.76	$831.76	$831.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $588.84 / $1,862.09	Professional		$446.68	$588.84	$1,862.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $295.12 / $371.54 / $1,174.90	Professional	26	$295.12	$371.54	$1,174.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $213.80 / $691.83	Professional	TC	$165.96	$213.80	$691.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $616.60 / $776.25	Professional		$562.34	$616.60	$776.25
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $363.08 / $389.05 / $489.78	Professional	26	$363.08	$389.05	$489.78
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $229.09 / $275.42	Professional	TC	$199.53	$229.09	$275.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $630.96 / $676.08	Professional		$371.54	$630.96	$676.08
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $234.42 / $416.87 / $436.52	Professional	26	$234.42	$416.87	$436.52
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $223.87 / $234.42	Professional	TC	$138.04	$223.87	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $562.34 / $724.44	Professional		$398.11	$562.34	$724.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $251.19 / $363.08 / $457.09	Professional	26	$251.19	$363.08	$457.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $204.17 / $263.03	Professional	TC	$147.91	$204.17	$263.03