Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.99 / $224.23 / $414.58	Facility	26	$116.99	$224.23	$414.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $272.08 / $425.00 / $1,700.00	Professional		$272.08	$425.00	$1,700.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.18 / $105.77 / $154.00	Professional	26	$70.18	$105.77	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $199.21 / $299.00 / $370.63	Professional	TC	$199.21	$299.00	$370.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $217.38 / $223.90 / $230.42	Facility	26	$217.38	$223.90	$230.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $349.28 / $646.11 / $1,040.83	Professional		$349.28	$646.11	$1,040.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.64 / $157.47 / $217.29	Professional	26	$73.64	$157.47	$217.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $288.41 / $490.74 / $861.44	Professional	TC	$288.41	$490.74	$861.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $232.10 / $430.89 / $1,335.42	Professional		$232.10	$430.89	$1,335.42
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.69 / $104.97 / $307.02	Professional	26	$64.69	$104.97	$307.02
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $167.41 / $314.58 / $1,138.61	Professional	TC	$167.41	$314.58	$1,138.61
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $505.36 / $653.60 / $653.60	Facility	26	$505.36	$653.60	$653.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $344.82 / $567.16 / $2,872.81	Professional		$344.82	$567.16	$2,872.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $74.98 / $121.27 / $548.98	Professional	26	$74.98	$121.27	$548.98
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $258.05 / $387.26 / $2,498.98	Professional	TC	$258.05	$387.26	$2,498.98
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $223.90 / $230.42 / $387.42	Facility	26	$223.90	$230.42	$387.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $508.26 / $647.21 / $902.30	Professional		$508.26	$647.21	$902.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $355.80 / $355.80 / $1,162.80	Professional		$355.80	$355.80	$1,162.80
United Facility/Professional Professional Modifier Low / Median / High Price $316.08 / $462.25 / $896.06	Professional		$316.08	$462.25	$896.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.48 / $108.47 / $251.54	Professional	26	$74.48	$108.47	$251.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $236.54 / $352.67 / $676.11	Professional	TC	$236.54	$352.67	$676.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $468.71 / $593.29 / $698.00	Professional		$468.71	$593.29	$698.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $121.74 / $154.10 / $181.30	Professional	26	$121.74	$154.10	$181.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $346.97 / $439.20 / $516.70	Professional	TC	$346.97	$439.20	$516.70