Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.26 / $208.25 / $555.22	Facility	26	$96.26	$208.25	$555.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.94 / $475.00 / $2,715.60	Professional		$347.94	$475.00	$2,715.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.20 / $140.00 / $541.16	Professional	26	$98.20	$140.00	$541.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $241.52 / $335.00 / $825.76	Professional	TC	$241.52	$335.00	$825.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $332.69 / $342.67 / $352.65	Facility	26	$332.69	$342.67	$352.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $550.00 / $953.46 / $1,691.55	Professional		$550.00	$953.46	$1,691.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.81 / $236.59 / $329.05	Professional	26	$110.81	$236.59	$329.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $385.00 / $706.86 / $1,416.74	Professional	TC	$385.00	$706.86	$1,416.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $299.41 / $513.80 / $2,433.46	Professional		$299.41	$513.80	$2,433.46
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.12 / $158.85 / $304.26	Professional	26	$97.12	$158.85	$304.26
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $202.30 / $355.35 / $2,133.12	Professional	TC	$202.30	$355.35	$2,133.12
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $759.68 / $973.04 / $973.04	Facility	26	$759.68	$973.04	$973.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $438.25 / $777.43 / $6,025.38	Professional		$438.25	$777.43	$6,025.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $112.79 / $182.40 / $891.52	Professional	26	$112.79	$182.40	$891.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $309.50 / $515.84 / $5,457.89	Professional	TC	$309.50	$515.84	$5,457.89
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $342.67 / $352.65 / $577.50	Facility	26	$342.67	$352.65	$577.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $649.19 / $967.89 / $1,569.00	Professional		$649.19	$967.89	$1,569.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $106.08 / $342.54 / $587.87	Professional		$106.08	$342.54	$587.87
United Facility/Professional Professional Modifier Low / Median / High Price $401.73 / $598.95 / $1,138.81	Professional		$401.73	$598.95	$1,138.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.66 / $160.94 / $328.71	Professional	26	$107.66	$160.94	$328.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $283.70 / $451.36 / $1,005.11	Professional	TC	$283.70	$451.36	$1,005.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $602.22 / $762.30 / $896.80	Professional		$602.22	$762.30	$896.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $182.89 / $231.50 / $272.39	Professional	26	$182.89	$231.50	$272.39
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $419.33 / $530.79 / $624.40	Professional	TC	$419.33	$530.79	$624.40