Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $85.11 / $316.23	Facility		$31.62	$85.11	$316.23
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 $21.38 / $47.86 / $208.93	Facility	TC	$21.38	$47.86	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $48.98 / $158.49	Professional		$26.92	$48.98	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.45 / $45.71	Professional	26	$7.08	$14.45	$45.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.84 / $104.71	Professional	TC	$19.05	$28.84	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $93.33 / $95.50	Facility		$89.13	$93.33	$95.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $26.92 / $27.54	Facility	26	$26.30	$26.92	$27.54
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $63.10 / $66.07 / $67.61	Facility	TC	$63.10	$66.07	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $77.62 / $97.72	Professional		$38.02	$77.62	$97.72
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 $27.54 / $58.88 / $74.13	Professional	TC	$27.54	$58.88	$74.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $47.86 / $120.23	Professional		$29.51	$47.86	$120.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.88 / $38.02	Professional	26	$7.76	$12.88	$38.02
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.11 / $75.86	Professional	TC	$21.88	$33.11	$75.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $75.86 / $346.74	Facility		$40.74	$75.86	$346.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $100.00 / $100.00	Facility	26	$26.92	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $66.07 / $109.65 / $109.65	Facility	TC	$66.07	$109.65	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $53.70 / $208.93	Professional		$28.84	$53.70	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.88 / $83.18	Professional	26	$8.71	$12.88	$83.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $28.18 / $177.83	Professional	TC	$19.50	$28.18	$177.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $69.18 / $83.18	Professional		$61.66	$69.18	$83.18
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 $45.71 / $52.48 / $61.66	Professional	TC	$45.71	$52.48	$61.66
Midlands Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $27.54 / $27.54	Facility	26	$27.54	$27.54	$27.54
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $67.61 / $67.61 / $67.61	Facility	TC	$67.61	$67.61	$67.61
Midlands Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $61.66 / $81.28	Professional		$53.70	$61.66	$81.28
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $19.50 / $25.12	Professional	26	$16.60	$19.50	$25.12
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $45.71 / $61.66	Professional	TC	$36.31	$45.71	$61.66
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $24.55 / $54.95	Professional		$8.71	$24.55	$54.95
United Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $199.53 / $269.15	Facility		$114.82	$199.53	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $36.31 / $67.61	Professional		$28.18	$36.31	$67.61
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 $19.50 / $25.70 / $48.98	Professional	TC	$19.50	$25.70	$48.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $66.07	Professional		$56.23	$56.23	$66.07
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 $41.69 / $41.69 / $48.98	Professional	TC	$41.69	$41.69	$48.98