Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $130.21 / $204.06 / $377.41	Facility	26	$130.21	$204.06	$377.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.32 / $425.00 / $700.00	Professional		$233.32	$425.00	$700.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.12 / $96.82 / $162.06	Professional	26	$64.12	$96.82	$162.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $167.60 / $299.00 / $368.50	Professional	TC	$167.60	$299.00	$368.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $200.36 / $206.37 / $212.38	Facility	26	$200.36	$206.37	$212.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $336.94 / $565.76 / $1,166.14	Professional		$336.94	$565.76	$1,166.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.16 / $144.28 / $215.60	Professional	26	$67.16	$144.28	$215.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $269.83 / $427.94 / $1,000.97	Professional	TC	$269.83	$427.94	$1,000.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $200.35 / $371.97 / $1,322.06	Professional		$200.35	$371.97	$1,322.06
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.06 / $98.98 / $328.41	Professional	26	$59.06	$98.98	$328.41
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $141.30 / $265.67 / $1,140.49	Professional	TC	$141.30	$265.67	$1,140.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $461.28 / $596.96 / $596.96	Facility	26	$461.28	$596.96	$596.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $292.08 / $488.88 / $2,821.00	Professional		$292.08	$488.88	$2,821.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $68.25 / $109.71 / $625.77	Professional	26	$68.25	$109.71	$625.77
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $213.26 / $355.44 / $2,451.15	Professional	TC	$213.26	$355.44	$2,451.15
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $206.37 / $212.38 / $354.06	Facility	26	$206.37	$212.38	$354.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $440.84 / $565.76 / $872.17	Professional		$440.84	$565.76	$872.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.26 / $210.72 / $374.53	Professional		$63.26	$210.72	$374.53
United Facility/Professional Professional Modifier Low / Median / High Price $264.89 / $399.18 / $757.23	Professional		$264.89	$399.18	$757.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.76 / $98.52 / $195.97	Professional	26	$67.76	$98.52	$195.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.29 / $274.86 / $555.60	Professional	TC	$181.29	$274.86	$555.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $404.01 / $511.40 / $601.70	Professional		$404.01	$511.40	$601.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $140.69 / $165.50	Professional	26	$111.15	$140.69	$165.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $292.85 / $370.70 / $436.10	Professional	TC	$292.85	$370.70	$436.10