Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $218.78 / $416.87	Facility		$75.86	$218.78	$416.87
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $8.32 / $16.98	Facility	26	$7.08	$8.32	$16.98
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.92 / $208.93 / $549.54	Facility	TC	$26.92	$208.93	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $42.66 / $181.97	Professional		$9.33	$42.66	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $16.60 / $57.54	Professional	26	$7.76	$16.60	$57.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $18.20 / $91.20 / $223.87	Professional	50	$18.20	$91.20	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $44.67 / $147.91	Professional	TC	$22.91	$44.67	$147.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $102.33 / $107.15	Facility		$100.00	$102.33	$107.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $26.92 / $27.54	Facility	26	$25.70	$26.92	$27.54
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $74.13 / $75.86 / $79.43	Facility	TC	$74.13	$75.86	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $89.13 / $112.20	Professional		$41.69	$89.13	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $19.05 / $23.99	Professional	26	$10.72	$19.05	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $69.18 / $87.10	Professional	TC	$30.20	$69.18	$87.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $51.29 / $128.82	Professional		$33.88	$51.29	$128.82
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.88 / $39.81	Professional	26	$7.76	$12.88	$39.81
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $38.02 / $97.72	Professional	TC	$25.70	$38.02	$97.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $104.71 / $346.74	Facility		$48.98	$104.71	$346.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $100.00 / $100.00	Facility	26	$26.92	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $75.86 / $131.83 / $208.93	Facility	TC	$75.86	$131.83	$208.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $57.54 / $234.42	Professional		$30.90	$57.54	$234.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.13 / $67.61	Professional	26	$8.71	$14.13	$67.61
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.88 / $181.97	Professional	TC	$21.88	$33.88	$181.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $79.43 / $120.23	Professional		$72.44	$79.43	$120.23
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $20.42 / $28.18	Professional	26	$16.98	$20.42	$28.18
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $61.66 / $93.33	Professional	TC	$41.69	$61.66	$93.33
Midlands Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $27.54 / $27.54	Facility	26	$27.54	$27.54	$27.54
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $79.43 / $79.43 / $79.43	Facility	TC	$79.43	$79.43	$79.43
Midlands Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $66.07 / $93.33	Professional		$60.26	$66.07	$93.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $19.50 / $25.12	Professional	26	$16.60	$19.50	$25.12
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $50.12 / $72.44	Professional	TC	$41.69	$50.12	$72.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $30.20 / $64.57	Professional		$9.12	$30.20	$64.57
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 $30.20 / $39.81 / $75.86	Professional		$30.20	$39.81	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.72 / $18.20	Professional	26	$8.51	$10.72	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $29.51 / $57.54	Professional	TC	$22.39	$29.51	$57.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $75.86	Professional		$64.57	$64.57	$75.86
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $14.45 / $16.98	Professional	26	$14.45	$14.45	$16.98
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $50.12 / $58.88	Professional	TC	$50.12	$50.12	$58.88