Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $204.17 / $436.52	Facility		$47.86	$204.17	$436.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $14.79 / $16.98	Facility	26	$7.08	$14.79	$16.98
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.60 / $48.98 / $416.87	Facility	TC	$16.60	$48.98	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $39.81 / $138.04	Professional		$22.91	$39.81	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $10.47 / $43.65	Professional	26	$7.24	$10.47	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $26.30 / $100.00	Professional	TC	$15.14	$26.30	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $85.11 / $87.10	Facility		$83.18	$85.11	$87.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $28.18 / $29.51	Facility	26	$27.54	$28.18	$29.51
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $54.95 / $56.23 / $58.88	Facility	TC	$54.95	$56.23	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $66.07 / $83.18	Professional		$35.48	$66.07	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $19.05 / $23.99	Professional	26	$10.72	$19.05	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $46.77 / $58.88	Professional	TC	$23.44	$46.77	$58.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $41.69 / $107.15	Professional		$25.12	$41.69	$107.15
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.88 / $39.81	Professional	26	$7.76	$12.88	$39.81
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $27.54 / $56.23	Professional	TC	$17.38	$27.54	$56.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $69.18 / $346.74	Facility		$39.81	$69.18	$346.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $100.00 / $100.00	Facility	26	$28.18	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $56.23 / $100.00 / $131.83	Facility	TC	$56.23	$100.00	$131.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $51.29 / $177.83	Professional		$26.30	$51.29	$177.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.88 / $77.62	Professional	26	$8.71	$12.88	$77.62
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $26.92 / $162.18	Professional	TC	$17.38	$26.92	$162.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $69.18 / $72.44	Professional		$54.95	$69.18	$72.44
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $19.50 / $26.30	Professional	26	$16.98	$19.50	$26.30
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $45.71 / $52.48	Professional	TC	$38.02	$45.71	$52.48
Midlands Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $29.51 / $29.51	Facility	26	$29.51	$29.51	$29.51
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $58.88 / $58.88 / $58.88	Facility	TC	$58.88	$58.88	$58.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $61.66 / $69.18	Professional		$56.23	$61.66	$69.18
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $19.50 / $23.99	Professional	26	$17.78	$19.50	$23.99
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $43.65 / $48.98	Professional	TC	$38.02	$43.65	$48.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $20.42 / $47.86	Professional		$8.71	$20.42	$47.86
United Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $239.88 / $323.59	Facility		$151.36	$239.88	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $33.88 / $64.57	Professional		$26.30	$33.88	$64.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.72 / $19.50	Professional	26	$8.51	$10.72	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $22.91 / $43.65	Professional	TC	$17.38	$22.91	$43.65
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $56.23	Professional		$47.86	$47.86	$56.23
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $14.45 / $16.98	Professional	26	$14.45	$14.45	$16.98
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $33.88 / $39.81	Professional	TC	$33.88	$33.88	$39.81