Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $213.80 / $389.05	Facility		$51.29	$213.80	$389.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $13.49 / $15.85	Facility	26	$6.03	$13.49	$15.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.62 / $56.23 / $269.15	Facility	TC	$18.62	$56.23	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $33.88 / $134.90	Professional		$10.47	$33.88	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.13 / $45.71	Professional	26	$7.08	$14.13	$45.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.78 / $117.49 / $144.54	Professional	50	$17.78	$117.49	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $30.20 / $114.82	Professional	TC	$16.98	$30.20	$114.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $89.13 / $91.20	Facility		$87.10	$89.13	$91.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $25.12 / $25.70	Facility	26	$24.55	$25.12	$25.70
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $61.66 / $64.57 / $66.07	Facility	TC	$61.66	$64.57	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $69.18 / $87.10	Professional		$35.48	$69.18	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $17.38 / $21.88	Professional	26	$9.77	$17.38	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $52.48 / $66.07	Professional	TC	$25.12	$52.48	$66.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $42.66 / $102.33	Professional		$26.30	$42.66	$102.33
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $11.75 / $31.62	Professional	26	$7.24	$11.75	$31.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $29.51 / $70.79	Professional	TC	$19.05	$29.51	$70.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $72.44 / $346.74	Facility		$38.90	$72.44	$346.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $100.00 / $100.00	Facility	26	$25.12	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $64.57 / $100.00 / $144.54	Facility	TC	$64.57	$100.00	$144.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $48.98 / $186.21	Professional		$26.92	$48.98	$186.21
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $12.30 / $64.57	Professional	26	$8.13	$12.30	$64.57
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $25.12 / $162.18	Professional	TC	$17.78	$25.12	$162.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $63.10 / $95.50	Professional		$54.95	$63.10	$95.50
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $19.05 / $25.70	Professional	26	$15.49	$19.05	$25.70
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $46.77 / $69.18	Professional	TC	$39.81	$46.77	$69.18
Midlands Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $25.70 / $25.70	Facility	26	$25.70	$25.70	$25.70
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $66.07 / $66.07 / $66.07	Facility	TC	$66.07	$66.07	$66.07
Midlands Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $57.54 / $72.44	Professional		$50.12	$57.54	$72.44
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $18.20 / $22.91	Professional	26	$15.49	$18.20	$22.91
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $40.74 / $53.70	Professional	TC	$33.11	$40.74	$53.70
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,513.56 / $1,995.26	Facility		$707.95	$1,513.56	$1,995.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $22.39 / $48.98	Professional		$7.94	$22.39	$48.98
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 $26.30 / $33.11 / $61.66	Professional		$26.30	$33.11	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.00 / $17.78	Professional	26	$8.13	$10.00	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $22.91 / $43.65	Professional	TC	$17.78	$22.91	$43.65
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $58.88	Professional		$50.12	$50.12	$58.88
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $13.18 / $15.49	Professional	26	$13.18	$13.18	$15.49
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $37.15 / $43.65	Professional	TC	$37.15	$37.15	$43.65