Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.13 / $76.23 / $129.74	Facility	26	$40.13	$76.23	$129.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.35 / $199.53 / $746.45	Professional		$106.35	$199.53	$746.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.02 / $42.83 / $143.32	Professional	26	$37.02	$42.83	$143.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.22 / $131.38 / $220.00	Professional	TC	$66.22	$131.38	$220.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.80 / $131.63 / $135.47	Facility	26	$127.80	$131.63	$135.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.04 / $262.13 / $462.76	Professional		$155.04	$262.13	$462.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.65 / $91.53 / $125.62	Professional	26	$42.65	$91.53	$125.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.43 / $187.37 / $358.81	Professional	TC	$112.43	$187.37	$358.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.64 / $176.71 / $603.61	Professional		$95.64	$176.71	$603.61
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.47 / $60.84 / $141.49	Professional	26	$37.47	$60.84	$141.49
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.17 / $109.31 / $465.32	Professional	TC	$58.17	$109.31	$465.32
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $292.88 / $376.16 / $376.16	Facility	26	$292.88	$376.16	$376.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $119.01 / $214.45 / $1,267.82	Professional		$119.01	$214.45	$1,267.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $43.40 / $62.39 / $315.37	Professional	26	$43.40	$62.39	$315.37
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $73.26 / $128.54 / $1,108.00	Professional	TC	$73.26	$128.54	$1,108.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $131.63 / $135.47 / $223.44	Facility	26	$131.63	$135.47	$223.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $204.33 / $247.51 / $386.00	Professional		$204.33	$247.51	$386.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.29 / $100.99 / $178.79	Professional		$40.29	$100.99	$178.79
United Facility/Professional Professional Modifier Low / Median / High Price $113.95 / $162.29 / $571.54	Professional		$113.95	$162.29	$571.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.59 / $49.91 / $92.33	Professional	26	$41.59	$49.91	$92.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.94 / $86.73 / $171.54	Professional	TC	$69.94	$86.73	$171.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $164.79 / $208.60 / $245.40	Professional		$164.79	$208.60	$245.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $60.83 / $77.00 / $90.60	Professional	26	$60.83	$77.00	$90.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $103.96 / $131.60 / $154.80	Professional	TC	$103.96	$131.60	$154.80