Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.10 / $183.64 / $296.18	Facility		$61.10	$183.64	$296.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.65 / $18.32 / $34.29	Facility	26	$9.65	$18.32	$34.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.27 / $35.36 / $151.00	Professional		$23.27	$35.36	$151.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $10.97 / $39.61	Professional	26	$9.41	$10.97	$39.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.19 / $24.22 / $51.04	Professional	TC	$20.19	$24.22	$51.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $101.84 / $104.90 / $107.95	Facility		$101.84	$104.90	$107.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.00 / $33.99 / $34.97	Facility	26	$33.00	$33.99	$34.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $85.33 / $116.74	Professional		$37.04	$85.33	$116.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.34 / $24.05 / $33.44	Professional	26	$11.34	$24.05	$33.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.71 / $61.28 / $78.23	Professional	TC	$25.71	$61.28	$78.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $32.10 / $50.07 / $107.27	Professional		$32.10	$50.07	$107.27
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.96 / $16.14 / $28.45	Professional	26	$9.96	$16.14	$28.45
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.14 / $34.36 / $56.37	Professional	TC	$22.14	$34.36	$56.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $43.53 / $71.48 / $239.94	Facility		$43.53	$71.48	$239.94
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $33.99 / $100.00 / $100.00	Facility	26	$33.99	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $55.71 / $236.90	Professional		$33.11	$55.71	$236.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.04 / $14.38 / $82.56	Professional	26	$11.04	$14.38	$82.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.75 / $29.45 / $190.00	Professional	TC	$21.75	$29.45	$190.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $62.00 / $78.28 / $124.53	Facility		$62.00	$78.28	$124.53
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $33.99 / $34.97 / $58.26	Facility	26	$33.99	$34.97	$58.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $71.48 / $116.74	Professional		$57.00	$71.48	$116.74
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $88.39 / $88.39 / $88.39	Facility		$88.39	$88.39	$88.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $32.81 / $60.65	Professional		$10.72	$32.81	$60.65
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $43.13 / $69.16	Professional		$33.11	$43.13	$69.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.04 / $14.38 / $24.32	Professional	26	$11.04	$14.38	$24.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.96 / $27.61 / $48.43	Professional	TC	$21.96	$27.61	$48.43
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $49.61 / $62.80 / $73.90	Professional		$49.61	$62.80	$73.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $14.46 / $18.30 / $21.50	Professional	26	$14.46	$18.30	$21.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $35.15 / $44.50 / $52.40	Professional	TC	$35.15	$44.50	$52.40