Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.05 / $210.00 / $388.16	Facility	26	$134.05	$210.00	$388.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.56 / $275.00 / $427.97	Professional		$193.56	$275.00	$427.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $62.95 / $247.37	Professional	26	$55.00	$62.95	$247.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.68 / $220.00 / $353.66	Professional	TC	$136.68	$220.00	$353.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $203.97 / $210.09 / $216.21	Facility	26	$203.97	$210.09	$216.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.27 / $476.75 / $898.45	Professional		$301.27	$476.75	$898.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.59 / $137.01 / $199.99	Professional	26	$62.59	$137.01	$199.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $231.32 / $347.71 / $730.44	Professional	TC	$231.32	$347.71	$730.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $174.42 / $323.36 / $1,100.26	Professional		$174.42	$323.36	$1,100.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.97 / $91.94 / $304.51	Professional	26	$54.97	$91.94	$304.51
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $119.45 / $224.51 / $909.92	Professional	TC	$119.45	$224.51	$909.92
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $429.60 / $553.04 / $553.04	Facility	26	$429.60	$553.04	$553.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $238.88 / $424.84 / $2,319.03	Professional		$238.88	$424.84	$2,319.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $68.78 / $87.80 / $543.21	Professional	26	$68.78	$87.80	$543.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $164.71 / $287.26 / $1,973.17	Professional	TC	$164.71	$287.26	$1,973.17
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $210.09 / $216.21 / $328.44	Facility	26	$210.09	$216.21	$328.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $377.29 / $518.74 / $746.00	Professional		$377.29	$518.74	$746.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.99 / $184.20 / $326.35	Professional		$58.99	$184.20	$326.35
United Facility/Professional Professional Modifier Low / Median / High Price $228.36 / $282.79 / $495.12	Professional		$228.36	$282.79	$495.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.42 / $87.80 / $153.72	Professional	26	$67.42	$87.80	$153.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.43 / $194.99 / $346.49	Professional	TC	$163.43	$194.99	$346.49
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $302.64 / $383.10 / $450.70	Professional		$302.64	$383.10	$450.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $89.19 / $112.90 / $132.90	Professional	26	$89.19	$112.90	$132.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $213.46 / $270.20 / $317.89	Professional	TC	$213.46	$270.20	$317.89