Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.43 / $245.65 / $492.37	Facility		$74.43	$245.65	$492.37
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.10 / $15.40 / $257.48	Facility	26	$8.10	$15.40	$257.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $36.27 / $256.63 / $545.16	Facility	TC	$36.27	$256.63	$545.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.90 / $36.39 / $130.00	Professional		$8.90	$36.39	$130.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $10.32 / $47.94	Professional	26	$8.11	$10.32	$47.94
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.27 / $64.59 / $107.48	Professional	50	$19.27	$64.59	$107.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.33 / $31.54 / $80.00	Professional	TC	$21.33	$31.54	$80.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.81 / $99.71 / $102.62	Facility		$96.81	$99.71	$102.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.14 / $32.07 / $33.01	Facility	26	$31.14	$32.07	$33.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $65.67 / $67.64 / $69.61	Facility	TC	$65.67	$67.64	$69.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.96 / $80.67 / $100.84	Professional		$34.96	$80.67	$100.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.58 / $20.17 / $28.05	Professional	26	$9.58	$20.17	$28.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.38 / $60.50 / $75.63	Professional	TC	$25.38	$60.50	$75.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $30.24 / $47.25 / $92.46	Professional		$30.24	$47.25	$92.46
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $13.42 / $37.93	Professional	26	$8.39	$13.42	$37.93
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.85 / $34.31 / $54.44	Professional	TC	$21.85	$34.31	$54.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $46.26 / $76.23 / $277.08	Facility		$46.26	$76.23	$277.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $32.07 / $100.00 / $100.00	Facility	26	$32.07	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $67.64 / $116.58 / $251.52	Facility	TC	$67.64	$116.58	$251.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.70 / $50.35 / $221.82	Professional		$30.70	$50.35	$221.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $12.07 / $89.16	Professional	26	$9.27	$12.07	$89.16
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.66 / $28.31 / $177.00	Professional	TC	$20.66	$28.31	$177.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $58.00 / $74.01 / $117.74	Facility		$58.00	$74.01	$117.74
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $32.07 / $33.01 / $50.40	Facility	26	$32.07	$33.01	$50.40
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $67.64 / $69.61 / $139.32	Facility	TC	$67.64	$69.61	$139.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $52.38 / $68.02 / $110.32	Professional		$52.38	$68.02	$110.32
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $436.43 / $2,370.40 / $4,825.47	Facility		$436.43	$2,370.40	$4,825.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.08 / $27.69 / $59.96	Professional		$9.08	$27.69	$59.96
United Facility/Professional Professional Modifier Low / Median / High Price $30.70 / $38.06 / $64.59	Professional		$30.70	$38.06	$64.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $11.69 / $19.67	Professional	26	$9.27	$11.69	$19.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.09 / $27.26 / $45.97	Professional	TC	$21.09	$27.26	$45.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $46.93 / $59.40 / $69.90	Professional		$46.93	$59.40	$69.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $12.17 / $15.40 / $18.10	Professional	26	$12.17	$15.40	$18.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $34.76 / $44.00 / $51.70	Professional	TC	$34.76	$44.00	$51.70