Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.57 / $89.20 / $244.63	Facility	26	$43.57	$89.20	$244.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.01 / $221.75 / $877.07	Professional		$130.01	$221.75	$877.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $52.10 / $245.00	Professional	26	$44.14	$52.10	$245.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.05 / $160.31 / $221.14	Professional	TC	$83.05	$160.31	$221.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $149.30 / $153.78 / $158.26	Facility	26	$149.30	$153.78	$158.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.35 / $321.30 / $590.90	Professional		$198.35	$321.30	$590.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.68 / $107.05 / $159.57	Professional	26	$49.68	$107.05	$159.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $139.87 / $213.12 / $468.45	Professional	TC	$139.87	$213.12	$468.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $116.09 / $214.90 / $749.19	Professional		$116.09	$214.90	$749.19
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.74 / $77.31 / $185.57	Professional	26	$43.74	$77.31	$185.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.34 / $136.04 / $595.27	Professional	TC	$72.34	$136.04	$595.27
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $341.52 / $442.24 / $442.24	Facility	26	$341.52	$442.24	$442.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $161.24 / $281.16 / $1,609.32	Professional		$161.24	$281.16	$1,609.32
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.50 / $68.87 / $379.76	Professional	26	$51.50	$68.87	$379.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $106.38 / $186.65 / $1,318.35	Professional	TC	$106.38	$186.65	$1,318.35
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $153.78 / $158.26 / $262.50	Facility	26	$153.78	$158.26	$262.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $249.92 / $341.90 / $506.00	Professional		$249.92	$341.90	$506.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.10 / $116.86 / $216.59	Professional		$47.10	$116.86	$216.59
United Facility/Professional Professional Modifier Low / Median / High Price $150.16 / $189.70 / $353.95	Professional		$150.16	$189.70	$353.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.96 / $62.44 / $111.65	Professional	26	$49.96	$62.44	$111.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $101.48 / $125.93 / $242.64	Professional	TC	$101.48	$125.93	$242.64
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $200.27 / $253.50 / $298.20	Professional		$200.27	$253.50	$298.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $70.94 / $89.80 / $105.70	Professional	26	$70.94	$89.80	$105.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $129.24 / $163.60 / $192.50	Professional	TC	$129.24	$163.60	$192.50