Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.06 / $203.47 / $525.15	Facility	26	$94.06	$203.47	$525.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $348.73 / $475.00 / $2,502.26	Professional		$348.73	$475.00	$2,502.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.68 / $140.02 / $513.24	Professional	26	$97.68	$140.02	$513.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.41 / $335.00 / $557.00	Professional	TC	$245.41	$335.00	$557.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $320.27 / $329.89 / $339.50	Facility	26	$320.27	$329.89	$339.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $550.00 / $834.49 / $1,655.94	Professional		$550.00	$834.49	$1,655.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.36 / $231.16 / $316.23	Professional	26	$108.36	$231.16	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $385.00 / $614.05 / $1,395.38	Professional	TC	$385.00	$614.05	$1,395.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $301.20 / $517.32 / $2,406.25	Professional		$301.20	$517.32	$2,406.25
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $94.93 / $155.19 / $628.47	Professional	26	$94.93	$155.19	$628.47
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $206.27 / $362.30 / $2,043.48	Professional	TC	$206.27	$362.30	$2,043.48
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $742.64 / $950.80 / $950.80	Facility	26	$742.64	$950.80	$950.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $436.87 / $766.35 / $5,981.06	Professional		$436.87	$766.35	$5,981.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $108.77 / $174.96 / $883.52	Professional	26	$108.77	$174.96	$883.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $311.07 / $518.46 / $5,438.76	Professional	TC	$311.07	$518.46	$5,438.76
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $329.89 / $339.50 / $564.05	Facility	26	$329.89	$339.50	$564.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $652.63 / $831.92 / $1,557.00	Professional		$652.63	$831.92	$1,557.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $102.17 / $317.05 / $564.15	Professional		$102.17	$317.05	$564.15
United Facility/Professional Professional Modifier Low / Median / High Price $391.45 / $618.90 / $1,131.83	Professional		$391.45	$618.90	$1,131.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $106.94 / $153.09 / $312.31	Professional	26	$106.94	$153.09	$312.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $286.19 / $453.65 / $976.94	Professional	TC	$286.19	$453.65	$976.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $606.33 / $767.50 / $902.90	Professional		$606.33	$767.50	$902.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $178.78 / $226.30 / $266.20	Professional	26	$178.78	$226.30	$266.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $427.55 / $541.20 / $636.70	Professional	TC	$427.55	$541.20	$636.70