Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $140.82 / $362.17	Facility	26	$64.84	$140.82	$362.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.84 / $472.55 / $1,376.33	Professional		$202.84	$472.55	$1,376.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.59 / $140.00 / $388.00	Professional	26	$67.59	$140.00	$388.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.21 / $294.39 / $422.10	Professional	TC	$124.21	$294.39	$422.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $238.46 / $245.61 / $252.77	Facility	26	$238.46	$245.61	$252.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $314.70 / $526.78 / $1,097.79	Professional		$314.70	$526.78	$1,097.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.29 / $159.02 / $239.64	Professional	26	$74.29	$159.02	$239.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.42 / $343.48 / $901.30	Professional	TC	$204.42	$343.48	$901.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $170.81 / $315.70 / $1,503.64	Professional		$170.81	$315.70	$1,503.64
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.26 / $107.36 / $250.27	Professional	26	$65.26	$107.36	$250.27
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $105.55 / $198.32 / $1,282.58	Professional	TC	$105.55	$198.32	$1,282.58
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $510.16 / $656.72 / $656.72	Facility	26	$510.16	$656.72	$656.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $244.08 / $439.26 / $3,174.82	Professional		$244.08	$439.26	$3,174.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $77.84 / $123.49 / $609.25	Professional	26	$77.84	$123.49	$609.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $156.91 / $261.52 / $2,772.01	Professional	TC	$156.91	$261.52	$2,772.01
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $245.61 / $252.77 / $389.22	Facility	26	$245.61	$252.77	$389.22
Midlands Facility/Professional Professional Modifier Low / Median / High Price $371.66 / $485.06 / $925.96	Professional		$371.66	$485.06	$925.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.04 / $180.18 / $319.45	Professional		$70.04	$180.18	$319.45
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $333.58 / $632.99	Professional		$218.78	$333.58	$632.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.65 / $108.96 / $222.43	Professional	26	$75.65	$108.96	$222.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $143.84 / $222.29 / $465.38	Professional	TC	$143.84	$222.29	$465.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $341.68 / $432.50 / $508.80	Professional		$341.68	$432.50	$508.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $122.92 / $155.60 / $183.00	Professional	26	$122.92	$155.60	$183.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $218.75 / $276.89 / $325.80	Professional	TC	$218.75	$276.89	$325.80