Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.59 / $170.92 / $441.60	Facility	26	$78.59	$170.92	$441.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $353.28 / $475.00 / $2,205.48	Professional		$353.28	$475.00	$2,205.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.02 / $136.18 / $322.00	Professional	26	$84.02	$136.18	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $266.48 / $335.00 / $535.73	Professional	TC	$266.48	$335.00	$535.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $265.89 / $273.87 / $281.83	Facility	26	$265.89	$273.87	$281.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $554.16 / $916.42 / $1,997.67	Professional		$554.16	$916.42	$1,997.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.88 / $193.15 / $265.57	Professional	26	$89.88	$193.15	$265.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $438.97 / $734.78 / $1,778.39	Professional	TC	$438.97	$734.78	$1,778.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $305.73 / $526.55 / $2,488.15	Professional		$305.73	$526.55	$2,488.15
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.03 / $129.69 / $420.16	Professional	26	$79.03	$129.69	$420.16
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $226.71 / $398.52 / $2,161.48	Professional	TC	$226.71	$398.52	$2,161.48
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $617.36 / $796.16 / $796.16	Facility	26	$617.36	$796.16	$796.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $399.33 / $773.27 / $5,311.18	Professional		$399.33	$773.27	$5,311.18
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $88.27 / $114.95 / $808.00	Professional	26	$88.27	$114.95	$808.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $302.23 / $530.29 / $4,858.99	Professional	TC	$302.23	$530.29	$4,858.99
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $273.87 / $281.83 / $472.50	Facility	26	$273.87	$281.83	$472.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $672.07 / $975.04 / $1,413.54	Professional		$672.07	$975.04	$1,413.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $84.69 / $321.43 / $572.13	Professional		$84.69	$321.43	$572.13
United Facility/Professional Professional Modifier Low / Median / High Price $372.58 / $472.74 / $1,014.19	Professional		$372.58	$472.74	$1,014.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.56 / $105.93 / $220.68	Professional	26	$87.56	$105.93	$220.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $274.76 / $412.14 / $2,379.19	Professional	TC	$274.76	$412.14	$2,379.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $618.65 / $783.10 / $921.30	Professional		$618.65	$783.10	$921.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $148.76 / $188.30 / $221.60	Professional	26	$148.76	$188.30	$221.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $469.89 / $594.79 / $699.80	Professional	TC	$469.89	$594.79	$699.80