Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.46 / $128.83 / $329.79	Facility	26	$102.46	$128.83	$329.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.74 / $475.00 / $1,928.31	Professional		$282.74	$475.00	$1,928.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.76 / $126.00 / $314.92	Professional	26	$64.76	$126.00	$314.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.04 / $335.00 / $561.04	Professional	TC	$223.04	$335.00	$561.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $202.56 / $208.64 / $214.71	Facility	26	$202.56	$208.64	$214.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $402.73 / $720.63 / $1,198.89	Professional		$402.73	$720.63	$1,198.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.81 / $145.83 / $199.61	Professional	26	$67.81	$145.83	$199.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $348.93 / $574.79 / $1,033.72	Professional	TC	$348.93	$574.79	$1,033.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $265.33 / $457.97 / $1,322.06	Professional		$265.33	$457.97	$1,322.06
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.62 / $97.88 / $223.46	Professional	26	$59.62	$97.88	$223.46
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $205.70 / $361.31 / $1,249.10	Professional	TC	$205.70	$361.31	$1,249.10
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $466.08 / $603.28 / $603.28	Facility	26	$466.08	$603.28	$603.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $393.82 / $633.39 / $2,819.97	Professional		$393.82	$633.39	$2,819.97
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.92 / $110.86 / $469.00	Professional	26	$67.92	$110.86	$469.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $313.29 / $458.24 / $2,495.53	Professional	TC	$313.29	$458.24	$2,495.53
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $208.64 / $214.71 / $357.66	Facility	26	$208.64	$214.71	$357.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $558.63 / $656.33 / $1,037.02	Professional		$558.63	$656.33	$1,037.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.20 / $278.10 / $535.86	Professional		$66.20	$278.10	$535.86
United Facility/Professional Professional Modifier Low / Median / High Price $361.00 / $492.27 / $1,020.75	Professional		$361.00	$492.27	$1,020.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.65 / $99.50 / $195.03	Professional	26	$67.65	$99.50	$195.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $289.82 / $455.24 / $818.12	Professional	TC	$289.82	$455.24	$818.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $538.70 / $681.90 / $802.20	Professional		$538.70	$681.90	$802.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $112.34 / $142.19 / $167.30	Professional	26	$112.34	$142.19	$167.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $426.36 / $539.70 / $635.00	Professional	TC	$426.36	$539.70	$635.00