Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.28 / $124.33 / $210.99	Facility	26	$60.28	$124.33	$210.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $185.18 / $285.17 / $1,172.06	Professional		$185.18	$285.17	$1,172.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.60 / $89.83 / $328.00	Professional	26	$61.60	$89.83	$328.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $118.85 / $220.00 / $364.25	Professional	TC	$118.85	$220.00	$364.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $205.79 / $211.96 / $218.14	Facility	26	$205.79	$211.96	$218.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.98 / $452.83 / $740.41	Professional		$247.98	$452.83	$740.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.90 / $148.16 / $220.67	Professional	26	$68.90	$148.16	$220.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $192.78 / $309.54 / $570.97	Professional	TC	$192.78	$309.54	$570.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $164.44 / $304.22 / $833.42	Professional		$164.44	$304.22	$833.42
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.59 / $98.12 / $227.05	Professional	26	$60.59	$98.12	$227.05
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $103.85 / $195.10 / $586.92	Professional	TC	$103.85	$195.10	$586.92
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $473.36 / $612.88 / $612.88	Facility	26	$473.36	$612.88	$612.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $208.99 / $366.68 / $1,680.90	Professional		$208.99	$366.68	$1,680.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.73 / $94.84 / $414.94	Professional	26	$67.73	$94.84	$414.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $134.47 / $215.95 / $1,425.00	Professional	TC	$134.47	$215.95	$1,425.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $211.96 / $218.14 / $363.60	Facility	26	$211.96	$218.14	$363.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $354.71 / $459.25 / $633.99	Professional		$354.71	$459.25	$633.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.92 / $173.29 / $307.36	Professional		$64.92	$173.29	$307.36
United Facility/Professional Professional Modifier Low / Median / High Price $199.49 / $247.40 / $433.18	Professional		$199.49	$247.40	$433.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.73 / $81.29 / $153.50	Professional	26	$67.73	$81.29	$153.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $133.52 / $159.19 / $277.12	Professional	TC	$133.52	$159.19	$277.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $283.93 / $359.40 / $422.80	Professional		$283.93	$359.40	$422.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $98.36 / $124.50 / $146.50	Professional	26	$98.36	$124.50	$146.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $185.57 / $234.90 / $276.30	Professional	TC	$185.57	$234.90	$276.30