Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $239.88 / $489.78	Facility		$58.88	$239.88	$489.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $15.85 / $257.04	Facility	26	$7.94	$15.85	$257.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.55 / $239.88 / $549.54	Facility	TC	$24.55	$239.88	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $38.90 / $169.82	Professional		$8.91	$38.90	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.18 / $51.29	Professional	26	$8.13	$13.18	$51.29
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $27.54 / $79.43 / $173.78	Professional	50	$27.54	$79.43	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $38.90 / $134.90	Professional	TC	$20.89	$38.90	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $100.00 / $102.33	Facility		$97.72	$100.00	$102.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $32.36 / $33.11	Facility	26	$30.90	$32.36	$33.11
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $66.07 / $67.61 / $69.18	Facility	TC	$66.07	$67.61	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $83.18 / $102.33	Professional		$39.81	$83.18	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $20.42 / $25.70	Professional	26	$11.22	$20.42	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $61.66 / $77.62	Professional	TC	$27.54	$61.66	$77.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $50.12 / $123.03	Professional		$30.90	$50.12	$123.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $13.80 / $45.71	Professional	26	$8.32	$13.80	$45.71
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $34.67 / $64.57	Professional	TC	$22.91	$34.67	$64.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $114.82 / $346.74	Facility		$48.98	$114.82	$346.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $100.00 / $100.00	Facility	26	$32.36	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $117.49 / $117.49 / $239.88	Facility	TC	$117.49	$117.49	$239.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $53.70 / $223.87	Professional		$30.90	$53.70	$223.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.14 / $89.13	Professional	26	$9.33	$15.14	$89.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $29.51 / $177.83	Professional	TC	$20.42	$29.51	$177.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $74.13 / $89.13	Professional		$66.07	$74.13	$89.13
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $21.88 / $30.20	Professional	26	$18.20	$21.88	$30.20
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $54.95 / $64.57	Professional	TC	$44.67	$54.95	$64.57
Midlands Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Facility		$102.33	$102.33	$102.33
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $33.11 / $33.11	Facility	26	$33.11	$33.11	$33.11
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $69.18 / $69.18 / $69.18	Facility	TC	$69.18	$69.18	$69.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $66.07 / $87.10	Professional		$56.23	$66.07	$87.10
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $20.89 / $25.70	Professional	26	$19.50	$20.89	$25.70
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $44.67 / $63.10	Professional	TC	$37.15	$44.67	$63.10
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $1,698.24 / $4,786.30	Facility		$436.52	$1,698.24	$4,786.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $27.54 / $60.26	Professional		$9.33	$27.54	$60.26
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 $29.51 / $38.02 / $70.79	Professional		$29.51	$38.02	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $11.48 / $21.38	Professional	26	$9.33	$11.48	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $26.30 / $51.29	Professional	TC	$20.42	$26.30	$51.29
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $69.18	Professional		$58.88	$58.88	$69.18
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $15.49 / $18.20	Professional	26	$15.49	$15.49	$18.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $43.65 / $51.29	Professional	TC	$43.65	$43.65	$51.29