Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $218.78 / $398.11	Facility		$70.79	$218.78	$398.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $9.55 / $18.62	Facility	26	$8.91	$9.55	$18.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.39 / $208.93 / $354.81	Facility	TC	$22.39	$208.93	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $44.67 / $154.88	Professional		$26.92	$44.67	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.49 / $46.77	Professional	26	$9.33	$13.49	$46.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.18 / $100.00	Professional	TC	$19.05	$28.18	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $97.72 / $102.33	Facility		$95.50	$97.72	$102.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $35.48 / $36.31	Facility	26	$34.67	$35.48	$36.31
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $61.66 / $63.10 / $64.57	Facility	TC	$61.66	$63.10	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $79.43 / $100.00	Professional		$36.31	$79.43	$100.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $23.99 / $29.51	Professional	26	$12.88	$23.99	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $56.23 / $70.79	Professional	TC	$22.91	$56.23	$70.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $51.29 / $120.23	Professional		$33.11	$51.29	$120.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $13.80 / $46.77	Professional	26	$9.55	$13.80	$46.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $31.62 / $69.18	Professional	TC	$22.39	$31.62	$69.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $144.54 / $346.74	Facility		$44.67	$144.54	$346.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $70.79 / $70.79	Facility	26	$35.48	$70.79	$70.79
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $95.50 / $107.15 / $173.78	Facility	TC	$95.50	$107.15	$173.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $58.88 / $213.80	Professional		$30.20	$58.88	$213.80
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $19.95 / $66.07	Professional	26	$11.22	$19.95	$66.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $26.30 / $147.91	Professional	TC	$18.62	$26.30	$147.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $72.44 / $85.11	Professional		$56.23	$72.44	$85.11
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $25.70 / $26.92	Professional	26	$20.42	$25.70	$26.92
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $50.12 / $58.88	Professional	TC	$35.48	$50.12	$58.88
Midlands Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Facility		$102.33	$102.33	$102.33
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $36.31 / $36.31	Facility	26	$36.31	$36.31	$36.31
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $64.57 / $64.57 / $64.57	Facility	TC	$64.57	$64.57	$64.57
Midlands Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $79.43 / $83.18	Professional		$58.88	$79.43	$83.18
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $24.55 / $26.30	Professional	26	$21.88	$24.55	$26.30
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $54.95 / $58.88	Professional	TC	$37.15	$54.95	$58.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $23.99 / $56.23	Professional		$10.47	$23.99	$56.23
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 $30.20 / $38.02 / $70.79	Professional		$30.20	$38.02	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $13.49 / $25.12	Professional	26	$10.72	$13.49	$25.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $24.55 / $46.77	Professional	TC	$18.62	$24.55	$46.77
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $67.61	Professional		$57.54	$57.54	$67.61
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $17.78 / $20.89	Professional	26	$17.78	$17.78	$20.89
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $39.81 / $46.77	Professional	TC	$39.81	$39.81	$46.77