Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.56 / $140.18 / $441.60	Facility	26	$64.56	$140.18	$441.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $336.37 / $475.00 / $700.00	Professional		$336.37	$475.00	$700.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.54 / $126.00 / $321.64	Professional	26	$68.54	$126.00	$321.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $265.18 / $335.00 / $500.05	Professional	TC	$265.18	$335.00	$500.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $267.30 / $275.32 / $283.33	Facility	26	$267.30	$275.32	$283.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $550.00 / $904.56 / $1,991.98	Professional		$550.00	$904.56	$1,991.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.75 / $161.79 / $220.70	Professional	26	$78.75	$161.79	$220.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $437.35 / $732.08 / $1,772.70	Professional	TC	$437.35	$732.08	$1,772.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $290.83 / $502.50 / $2,488.15	Professional		$290.83	$502.50	$2,488.15
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.98 / $106.52 / $276.82	Professional	26	$64.98	$106.52	$276.82
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $225.85 / $397.04 / $2,247.90	Professional	TC	$225.85	$397.04	$2,247.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $507.76 / $656.72 / $656.72	Facility	26	$507.76	$656.72	$656.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $379.98 / $799.59 / $5,311.18	Professional		$379.98	$799.59	$5,311.18
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $75.81 / $101.79 / $808.00	Professional	26	$75.81	$101.79	$808.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $300.08 / $526.50 / $4,858.99	Professional	TC	$300.08	$526.50	$4,858.99
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $275.32 / $283.33 / $389.22	Facility	26	$275.32	$283.33	$389.22
Midlands Facility/Professional Professional Modifier Low / Median / High Price $640.63 / $931.68 / $1,409.98	Professional		$640.63	$931.68	$1,409.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $69.70 / $305.95 / $544.66	Professional		$69.70	$305.95	$544.66
United Facility/Professional Professional Modifier Low / Median / High Price $352.38 / $449.83 / $980.43	Professional		$352.38	$449.83	$980.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.64 / $94.59 / $206.17	Professional	26	$72.64	$94.59	$206.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $278.27 / $355.24 / $910.88	Professional	TC	$278.27	$355.24	$910.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $590.45 / $747.40 / $879.30	Professional		$590.45	$747.40	$879.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $122.29 / $154.80 / $182.20	Professional	26	$122.29	$154.80	$182.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $468.15 / $592.60 / $697.10	Professional	TC	$468.15	$592.60	$697.10