Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $143.12 / $273.98 / $506.16	Facility	26	$143.12	$273.98	$506.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $341.97 / $475.00 / $1,460.00	Professional		$341.97	$475.00	$1,460.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $128.00 / $216.02	Professional	26	$85.00	$128.00	$216.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $255.30 / $335.00 / $517.62	Professional	TC	$255.30	$335.00	$517.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $270.11 / $278.20 / $286.32	Facility	26	$270.11	$278.20	$286.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $439.60 / $815.86 / $1,309.95	Professional		$439.60	$815.86	$1,309.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.58 / $192.37 / $264.69	Professional	26	$89.58	$192.37	$264.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $367.08 / $620.03 / $1,087.83	Professional	TC	$367.08	$620.03	$1,087.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $294.70 / $547.51 / $1,647.70	Professional		$294.70	$547.51	$1,647.70
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $78.78 / $127.55 / $397.62	Professional	26	$78.78	$127.55	$397.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $215.93 / $405.71 / $1,250.08	Professional	TC	$215.93	$405.71	$1,250.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $614.96 / $793.04 / $793.04	Facility	26	$614.96	$793.04	$793.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $393.61 / $669.72 / $3,032.66	Professional		$393.61	$669.72	$3,032.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.65 / $114.14 / $854.80	Professional	26	$87.65	$114.14	$854.80
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $291.02 / $417.84 / $2,562.41	Professional	TC	$291.02	$417.84	$2,562.41
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $278.20 / $286.32 / $470.88	Facility	26	$278.20	$286.32	$470.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $641.85 / $815.86 / $1,146.84	Professional		$641.85	$815.86	$1,146.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $452.60 / $452.60 / $1,464.00	Professional		$452.60	$452.60	$1,464.00
United Facility/Professional Professional Modifier Low / Median / High Price $365.02 / $465.97 / $1,194.79	Professional		$365.02	$465.97	$1,194.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.65 / $110.01 / $256.32	Professional	26	$87.65	$110.01	$256.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $272.27 / $351.83 / $706.78	Professional	TC	$272.27	$351.83	$706.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $595.74 / $754.10 / $887.20	Professional		$595.74	$754.10	$887.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $148.19 / $187.60 / $220.70	Professional	26	$148.19	$187.60	$220.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $447.54 / $566.50 / $666.50	Professional	TC	$447.54	$566.50	$666.50