Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.13 / $228.27 / $631.38	Facility		$46.13	$228.27	$631.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.50 / $14.25 / $27.23	Facility	26	$7.50	$14.25	$27.23
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.28 / $58.86 / $413.45	Facility	TC	$17.28	$58.86	$413.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.22 / $29.27 / $127.00	Professional		$24.22	$29.27	$127.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $8.92 / $42.49	Professional	26	$7.50	$8.92	$42.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.35 / $19.26 / $63.36	Professional	TC	$16.35	$19.26	$63.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.80 / $85.28 / $87.77	Facility		$82.80	$85.28	$87.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.66 / $28.49 / $29.32	Facility	26	$27.66	$28.49	$29.32
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $55.14 / $56.79 / $58.45	Facility	TC	$55.14	$56.79	$58.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.38 / $64.38 / $80.48	Professional		$28.38	$64.38	$80.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.89 / $18.62 / $25.89	Professional	26	$8.89	$18.62	$25.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $45.77 / $57.21	Professional	TC	$19.48	$45.77	$57.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $24.53 / $41.15 / $84.24	Professional		$24.53	$41.15	$84.24
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $12.72 / $28.00	Professional	26	$7.78	$12.72	$28.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.75 / $26.80 / $45.12	Professional	TC	$16.75	$26.80	$45.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.39 / $59.41 / $283.83	Facility		$37.39	$59.41	$283.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $28.49 / $100.00 / $100.00	Facility	26	$28.49	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $56.79 / $100.00 / $132.31	Facility	TC	$56.79	$100.00	$132.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.41 / $46.63 / $178.47	Professional		$26.41	$46.63	$178.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.64 / $11.22 / $77.59	Professional	26	$8.64	$11.22	$77.59
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $17.82 / $23.82 / $163.00	Professional	TC	$17.82	$23.82	$163.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $51.00 / $59.77 / $95.10	Facility		$51.00	$59.77	$95.10
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $28.49 / $29.32 / $46.62	Facility	26	$28.49	$29.32	$46.62
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $56.79 / $58.45 / $105.06	Facility	TC	$56.79	$58.45	$105.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $59.77 / $95.10	Professional		$48.00	$59.77	$95.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.50 / $24.99 / $47.37	Professional		$8.50	$24.99	$47.37
United Facility/Professional Professional Modifier Low / Median / High Price $26.41 / $32.75 / $55.67	Professional		$26.41	$32.75	$55.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.58 / $10.64 / $18.00	Professional	26	$8.58	$10.64	$18.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.82 / $22.62 / $38.25	Professional	TC	$17.82	$22.62	$38.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $37.92 / $48.00 / $56.40	Professional		$37.92	$48.00	$56.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $11.30 / $14.30 / $16.80	Professional	26	$11.30	$14.30	$16.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $26.62 / $33.70 / $39.60	Professional	TC	$26.62	$33.70	$39.60