Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $361.71 / $441.12 / $491.71	Professional		$361.71	$441.12	$491.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.39 / $124.50 / $125.69	Professional	26	$92.39	$124.50	$125.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.31 / $316.62 / $366.01	Professional	TC	$269.31	$316.62	$366.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $605.52 / $744.24 / $813.19	Professional		$605.52	$744.24	$813.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $181.96 / $223.39 / $257.26	Professional	26	$181.96	$223.39	$257.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $423.59 / $529.45 / $588.49	Professional	TC	$423.59	$529.45	$588.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $167.42 / $420.33 / $846.60	Professional		$167.42	$420.33	$846.60
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.91 / $139.47 / $239.16	Professional	26	$77.91	$139.47	$239.16
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.95 / $289.85 / $494.85	Professional	TC	$27.95	$289.85	$494.85
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $378.47 / $378.47 / $378.47	Facility	26	$378.47	$378.47	$378.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $367.44 / $659.50 / $2,227.92	Professional		$367.44	$659.50	$2,227.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $99.62 / $200.91 / $684.00	Professional	26	$99.62	$200.91	$684.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $227.40 / $458.59 / $1,600.96	Professional	TC	$227.40	$458.59	$1,600.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $399.59 / $638.11 / $834.60	Professional		$399.59	$638.11	$834.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $497.30 / $827.50	Professional		$3.00	$497.30	$827.50
United Facility/Professional Professional Modifier Low / Median / High Price $327.02 / $653.58 / $1,071.46	Professional		$327.02	$653.58	$1,071.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.47 / $171.02 / $270.26	Professional	26	$95.47	$171.02	$270.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.93 / $356.59 / $616.87	Professional	TC	$217.93	$356.59	$616.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $533.90 / $533.90 / $628.20	Professional		$533.90	$533.90	$628.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $160.40 / $160.40 / $188.80	Professional	26	$160.40	$160.40	$188.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $373.50 / $373.50 / $439.40	Professional	TC	$373.50	$373.50	$439.40