Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.56 / $144.78 / $355.08	Facility	26	$70.56	$144.78	$355.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.99 / $279.24 / $670.99	Professional		$221.99	$279.24	$670.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $76.20 / $221.38	Professional	26	$55.00	$76.20	$221.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.63 / $202.51 / $341.05	Professional	TC	$144.63	$202.51	$341.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.71 / $220.12 / $226.53	Facility	26	$213.71	$220.12	$226.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.33 / $545.08 / $889.91	Professional		$298.33	$545.08	$889.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.05 / $172.98 / $240.59	Professional	26	$79.05	$172.98	$240.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.81 / $369.91 / $713.35	Professional	TC	$220.81	$369.91	$713.35
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $197.18 / $365.06 / $944.39	Professional		$197.18	$365.06	$944.39
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.92 / $113.93 / $312.06	Professional	26	$70.92	$113.93	$312.06
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $126.26 / $237.33 / $732.19	Professional	TC	$126.26	$237.33	$732.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $553.91 / $714.16 / $714.16	Facility	26	$553.91	$714.16	$714.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $252.15 / $442.42 / $2,036.01	Professional		$252.15	$442.42	$2,036.01
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $78.56 / $103.50 / $484.69	Professional	26	$78.56	$103.50	$484.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $164.72 / $264.95 / $2,005.00	Professional	TC	$164.72	$264.95	$2,005.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $220.12 / $226.53 / $423.96	Facility	26	$220.12	$226.53	$423.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $425.55 / $545.08 / $760.80	Professional		$425.55	$545.08	$760.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.95 / $199.29 / $368.35	Professional		$75.95	$199.29	$368.35
United Facility/Professional Professional Modifier Low / Median / High Price $240.01 / $298.50 / $518.88	Professional		$240.01	$298.50	$518.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.36 / $95.38 / $185.19	Professional	26	$73.36	$95.38	$185.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $157.24 / $224.63 / $341.43	Professional	TC	$157.24	$224.63	$341.43
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $340.73 / $431.30 / $507.40	Professional		$340.73	$431.30	$507.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $115.10 / $145.69 / $171.40	Professional	26	$115.10	$145.69	$171.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $225.62 / $285.60 / $336.00	Professional	TC	$225.62	$285.60	$336.00