Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $213.80 / $426.58	Facility		$44.67	$213.80	$426.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $8.71 / $17.78	Facility	26	$7.08	$8.71	$17.78
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $14.79 / $123.03 / $331.13	Facility	TC	$14.79	$123.03	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $32.36 / $114.82	Professional		$19.05	$32.36	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.33 / $40.74	Professional	26	$7.76	$9.33	$40.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $18.20 / $48.98	Professional	TC	$10.96	$18.20	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $64.57 / $66.07	Facility		$63.10	$64.57	$66.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $30.20 / $30.90	Facility	26	$28.84	$30.20	$30.90
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $33.11 / $34.67 / $35.48	Facility	TC	$33.11	$34.67	$35.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $61.66 / $75.86	Professional		$24.55	$61.66	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $19.95 / $24.55	Professional	26	$10.72	$19.95	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $41.69 / $51.29	Professional	TC	$13.18	$41.69	$51.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $40.74 / $95.50	Professional		$25.70	$40.74	$95.50
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.18 / $39.81	Professional	26	$8.91	$13.18	$39.81
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $21.88 / $44.67	Professional	TC	$15.49	$21.88	$44.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $109.65 / $275.42	Facility		$28.84	$109.65	$275.42
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $70.79 / $70.79	Facility	26	$30.20	$70.79	$70.79
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $77.62 / $79.43 / $138.04	Facility	TC	$77.62	$79.43	$138.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $38.90 / $165.96	Professional		$20.89	$38.90	$165.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.49 / $54.95	Professional	26	$9.33	$15.49	$54.95
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $18.62 / $109.65	Professional	TC	$10.72	$18.62	$109.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $54.95 / $64.57	Professional		$43.65	$54.95	$64.57
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $19.95 / $21.38	Professional	26	$16.98	$19.95	$21.38
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $37.15 / $43.65	Professional	TC	$26.92	$37.15	$43.65
Midlands Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $66.07	Facility		$66.07	$66.07	$66.07
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	26	$30.90	$30.90	$30.90
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $35.48 / $35.48 / $35.48	Facility	TC	$35.48	$35.48	$35.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $61.66 / $64.57	Professional		$38.90	$61.66	$64.57
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $20.42 / $21.38	Professional	26	$18.20	$20.42	$21.38
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $38.90 / $43.65	Professional	TC	$19.95	$38.90	$43.65
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $7,413.10 / $10,232.93	Facility		$1,047.13	$7,413.10	$10,232.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $18.62 / $43.65	Professional		$8.71	$18.62	$43.65
United Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $199.53 / $269.15	Facility		$114.82	$199.53	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $28.84 / $53.70	Professional		$20.89	$28.84	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.22 / $20.89	Professional	26	$8.91	$11.22	$20.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $18.20 / $31.62	Professional	TC	$10.72	$18.20	$31.62
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $52.48	Professional		$44.67	$44.67	$52.48
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $14.79 / $17.38	Professional	26	$14.79	$14.79	$17.38
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $29.51 / $34.67	Professional	TC	$29.51	$29.51	$34.67