Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $213.80 / $213.80	Facility	26	$95.50	$213.80	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $323.59 / $537.03	Professional		$245.47	$323.59	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $104.71 / $177.83	Professional	26	$91.20	$104.71	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $208.93 / $380.19	Professional	TC	$147.91	$208.93	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Professional		$251.19	$251.19	$251.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $436.52 / $602.56	Professional		$263.03	$436.52	$602.56
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $154.88 / $208.93	Professional	26	$93.33	$154.88	$208.93
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $281.84 / $389.05	Professional	TC	$169.82	$281.84	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $575.44 / $794.33	Professional		$323.59	$575.44	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $204.17 / $263.03	Professional	26	$112.20	$204.17	$263.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $371.54 / $524.81	Professional	TC	$213.80	$371.54	$524.81
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $478.63 / $1,995.26	Professional		$354.81	$478.63	$1,995.26
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $194.98 / $724.44	Professional	26	$158.49	$194.98	$724.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $281.84 / $1,584.89	Professional	TC	$223.87	$281.84	$1,584.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $562.34 / $691.83	Professional		$512.86	$562.34	$691.83
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $213.80 / $269.15	Professional	26	$199.53	$213.80	$269.15
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $346.74 / $446.68	Professional	TC	$309.03	$346.74	$446.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $645.65 / $676.08	Professional		$346.74	$645.65	$676.08
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $223.87 / $239.88	Professional	26	$128.82	$223.87	$239.88
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $407.38 / $426.58	Professional	TC	$218.78	$407.38	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $467.74 / $660.69	Professional		$338.84	$467.74	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $190.55 / $251.19	Professional	26	$134.90	$190.55	$251.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $281.84 / $426.58	Professional	TC	$208.93	$281.84	$426.58