Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.51 / $217.43 / $562.25	Facility	26	$100.51	$217.43	$562.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $329.89 / $475.00 / $1,987.26	Professional		$329.89	$475.00	$1,987.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.72 / $143.00 / $615.33	Professional	26	$104.72	$143.00	$615.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.58 / $335.00 / $443.49	Professional	TC	$218.58	$335.00	$443.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $380.51 / $391.93 / $403.34	Facility	26	$380.51	$391.93	$403.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $518.20 / $885.16 / $1,544.88	Professional		$518.20	$885.16	$1,544.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $115.85 / $246.67 / $367.16	Professional	26	$115.85	$246.67	$367.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $357.74 / $607.70 / $1,230.21	Professional	TC	$357.74	$607.70	$1,230.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $286.17 / $529.10 / $2,358.44	Professional		$286.17	$529.10	$2,358.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $101.46 / $171.92 / $416.27	Professional	26	$101.46	$171.92	$416.27
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $184.71 / $347.18 / $2,016.88	Professional	TC	$184.71	$347.18	$2,016.88
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $794.00 / $1,016.96 / $1,016.96	Facility	26	$794.00	$1,016.96	$1,016.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $413.83 / $730.18 / $6,195.24	Professional		$413.83	$730.18	$6,195.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $123.37 / $190.66 / $931.20	Professional	26	$123.37	$190.66	$931.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $279.25 / $465.42 / $5,551.18	Professional	TC	$279.25	$465.42	$5,551.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $391.93 / $403.34 / $603.00	Facility	26	$391.93	$403.34	$603.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $618.35 / $785.74 / $1,614.00	Professional		$618.35	$785.74	$1,614.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $109.27 / $300.88 / $536.16	Professional		$109.27	$300.88	$536.16
United Facility/Professional Professional Modifier Low / Median / High Price $381.69 / $603.51 / $2,635.26	Professional		$381.69	$603.51	$2,635.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $123.37 / $168.23 / $361.50	Professional	26	$123.37	$168.23	$361.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.34 / $359.74 / $807.47	Professional	TC	$244.34	$359.74	$807.47
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $574.01 / $726.60 / $854.80	Professional		$574.01	$726.60	$854.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $191.10 / $241.90 / $284.60	Professional	26	$191.10	$241.90	$284.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $382.83 / $484.60 / $570.10	Professional	TC	$382.83	$484.60	$570.10