Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.21 / $109.21 / $298.12	Facility	26	$109.21	$109.21	$298.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.45 / $275.00 / $455.30	Professional		$226.45	$275.00	$455.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $57.48 / $95.74	Professional	26	$52.46	$57.48	$95.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.97 / $220.00 / $357.10	Professional	TC	$168.97	$220.00	$357.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.37 / $186.81 / $192.25	Facility	26	$181.37	$186.81	$192.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $310.63 / $599.62 / $891.33	Professional		$310.63	$599.62	$891.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.69 / $131.09 / $179.45	Professional	26	$60.69	$131.09	$179.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $250.40 / $468.52 / $741.83	Professional	TC	$250.40	$468.52	$741.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $221.10 / $411.67 / $1,041.35	Professional		$221.10	$411.67	$1,041.35
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.42 / $86.34 / $240.33	Professional	26	$53.42	$86.34	$240.33
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $167.68 / $315.37 / $877.45	Professional	TC	$167.68	$315.37	$877.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $417.20 / $537.20 / $537.20	Facility	26	$417.20	$537.20	$537.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $278.77 / $489.14 / $2,195.67	Professional		$278.77	$489.14	$2,195.67
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $60.88 / $77.72 / $439.20	Professional	26	$60.88	$77.72	$439.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $213.13 / $314.12 / $1,890.23	Professional	TC	$213.13	$314.12	$1,890.23
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $186.81 / $192.25 / $318.95	Facility	26	$186.81	$192.25	$318.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $439.60 / $541.07 / $816.26	Professional		$439.60	$541.07	$816.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.36 / $200.37 / $413.17	Professional		$57.36	$200.37	$413.17
United Facility/Professional Professional Modifier Low / Median / High Price $271.93 / $330.03 / $577.84	Professional		$271.93	$330.03	$577.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.68 / $77.20 / $136.07	Professional	26	$59.68	$77.20	$136.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $212.51 / $256.81 / $471.81	Professional	TC	$212.51	$256.81	$471.81
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $386.31 / $489.00 / $575.29	Professional		$386.31	$489.00	$575.29
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $86.66 / $109.70 / $129.10	Professional	26	$86.66	$109.70	$129.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $299.64 / $379.30 / $446.20	Professional	TC	$299.64	$379.30	$446.20