Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $138.04 / $151.36	Facility	26	$64.57	$138.04	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $478.63 / $2,137.96	Professional		$338.84	$478.63	$2,137.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $141.25 / $436.52	Professional	26	$70.79	$141.25	$436.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $338.84 / $954.99	Professional	TC	$257.04	$338.84	$954.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $275.42 / $281.84	Facility	26	$269.15	$275.42	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $912.01 / $1,258.93	Professional		$549.54	$912.01	$1,258.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $162.18 / $218.78	Professional	26	$93.33	$162.18	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $741.31 / $1,071.52	Professional	TC	$436.52	$741.31	$1,071.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $575.44 / $2,951.21	Professional		$302.00	$575.44	$2,951.21
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $125.89 / $467.74	Professional	26	$64.57	$125.89	$467.74
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $446.68 / $2,630.27	Professional	TC	$234.42	$446.68	$2,630.27
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $512.86 / $660.69 / $660.69	Facility	26	$512.86	$660.69	$660.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $912.01 / $5,370.32	Professional		$380.19	$912.01	$5,370.32
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $109.65 / $812.83	Professional	26	$72.44	$109.65	$812.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $707.95 / $4,897.79	Professional	TC	$288.40	$707.95	$4,897.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,047.13 / $1,412.54	Professional		$660.69	$1,047.13	$1,412.54
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $181.97 / $218.78	Professional	26	$141.25	$181.97	$218.78
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $831.76 / $1,202.26	Professional	TC	$524.81	$831.76	$1,202.26
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $281.84 / $281.84 / $281.84	Facility	26	$281.84	$281.84	$281.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,000.00 / $1,412.54	Professional		$794.33	$1,000.00	$1,412.54
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $186.21 / $245.47	Professional	26	$154.88	$186.21	$245.47
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $616.60 / $812.83 / $1,258.93	Professional	TC	$616.60	$812.83	$1,258.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $269.15 / $575.44	Professional		$70.79	$269.15	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $524.81 / $1,023.29	Professional		$346.74	$524.81	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $93.33 / $204.17	Professional	26	$72.44	$93.33	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $426.58 / $912.01	Professional	TC	$275.42	$426.58	$912.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $870.96	Professional		$741.31	$741.31	$870.96
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $154.88 / $181.97	Professional	26	$154.88	$154.88	$181.97
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $588.84 / $691.83	Professional	TC	$588.84	$588.84	$691.83