Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.26 / $127.06 / $234.67	Facility	26	$62.26	$127.06	$234.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.95 / $103.15 / $149.65	Professional		$87.95	$103.15	$149.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.31 / $65.06 / $102.58	Professional	TC	$54.31	$65.06	$102.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.90 / $127.62 / $131.33	Facility	26	$123.90	$127.62	$131.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.72 / $252.88 / $337.45	Professional		$112.72	$252.88	$337.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.56 / $162.12 / $234.93	Professional	TC	$79.56	$162.12	$234.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.27 / $176.08 / $472.19	Professional		$95.27	$176.08	$472.19
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.11 / $60.36 / $198.81	Professional	26	$37.11	$60.36	$198.81
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.17 / $109.31 / $317.73	Professional	TC	$58.17	$109.31	$317.73
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $94.01 / $180.13 / $180.13	Facility	26	$94.01	$180.13	$180.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $106.34 / $186.57 / $1,114.04	Professional		$106.34	$186.57	$1,114.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $59.66 / $96.63 / $909.46	Professional	TC	$59.66	$96.63	$909.46
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $127.62 / $131.33 / $221.28	Facility	26	$127.62	$131.33	$221.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $178.46 / $230.56 / $366.80	Professional		$178.46	$230.56	$366.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.03 / $75.84 / $186.16	Professional		$40.03	$75.84	$186.16
United Facility/Professional Professional Modifier Low / Median / High Price $96.67 / $125.88 / $206.38	Professional		$96.67	$125.88	$206.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.98 / $73.95 / $129.82	Professional	TC	$56.98	$73.95	$129.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $146.15 / $185.00 / $217.60	Professional		$146.15	$185.00	$217.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $92.43 / $117.00 / $137.69	Professional	TC	$92.43	$117.00	$137.69