Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.16 / $177.23 / $371.14	Facility		$53.16	$177.23	$371.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.09 / $13.66 / $43.49	Facility	26	$7.09	$13.66	$43.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.41 / $48.81 / $194.65	Facility	TC	$21.41	$48.81	$194.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.30 / $32.17 / $123.00	Professional		$20.30	$32.17	$123.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.18 / $8.94 / $42.49	Professional	26	$7.18	$8.94	$42.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $22.42 / $53.68	Professional	TC	$18.82	$22.42	$53.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.49 / $94.23 / $96.98	Facility		$91.49	$94.23	$96.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.94 / $26.72 / $27.50	Facility	26	$25.94	$26.72	$27.50
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $65.55 / $67.52 / $69.48	Facility	TC	$65.55	$67.52	$69.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.28 / $74.47 / $93.08	Professional		$32.28	$74.47	$93.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.21 / $17.16 / $25.00	Professional	26	$8.21	$17.16	$25.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.07 / $57.40 / $71.75	Professional	TC	$24.07	$57.40	$71.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $27.89 / $45.20 / $91.43	Professional		$27.89	$45.20	$91.43
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.17 / $11.72 / $27.73	Professional	26	$7.17	$11.72	$27.73
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.72 / $32.54 / $54.44	Professional	TC	$20.72	$32.54	$54.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.70 / $64.28 / $239.94	Facility		$39.70	$64.28	$239.94
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.72 / $100.00 / $100.00	Facility	26	$26.72	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $67.52 / $110.49 / $110.49	Facility	TC	$67.52	$110.49	$110.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.99 / $50.15 / $204.50	Professional		$28.99	$50.15	$204.50
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.64 / $10.70 / $74.30	Professional	26	$8.64	$10.70	$74.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.77 / $27.72 / $176.00	Professional	TC	$20.77	$27.72	$176.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $68.31 / $108.68	Facility		$56.00	$68.31	$108.68
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $26.72 / $27.50 / $42.84	Facility	26	$26.72	$27.50	$42.84
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $67.52 / $69.48 / $130.32	Facility	TC	$67.52	$69.48	$130.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $51.27 / $62.13 / $108.68	Professional		$51.27	$62.13	$108.68
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $264.87 / $1,923.10 / $3,321.70	Facility		$264.87	$1,923.10	$3,321.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.00 / $28.51 / $53.85	Professional		$8.00	$28.51	$53.85
United Facility/Professional Professional Modifier Low / Median / High Price $28.99 / $35.94 / $58.74	Professional		$28.99	$35.94	$58.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $10.56 / $17.32	Professional	26	$8.22	$10.56	$17.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.77 / $25.75 / $42.31	Professional	TC	$20.77	$25.75	$42.31
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $43.29 / $54.80 / $64.50	Professional		$43.29	$54.80	$64.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $13.10 / $15.40	Professional	26	$10.35	$13.10	$15.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $32.94 / $41.70 / $49.00	Professional	TC	$32.94	$41.70	$49.00