Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.34 / $204.09 / $527.46	Facility	26	$94.34	$204.09	$527.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $279.00 / $475.00 / $1,307.79	Professional		$279.00	$475.00	$1,307.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $128.00 / $322.00	Professional	26	$85.00	$128.00	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $304.92 / $335.00 / $648.29	Professional	TC	$304.92	$335.00	$648.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $322.83 / $332.51 / $342.20	Facility	26	$322.83	$332.51	$342.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $565.04 / $1,010.92 / $1,683.00	Professional		$565.04	$1,010.92	$1,683.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.69 / $231.93 / $317.23	Professional	26	$108.69	$231.93	$317.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $458.16 / $776.38 / $1,419.58	Professional	TC	$458.16	$776.38	$1,419.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $361.35 / $611.79 / $2,420.73	Professional		$361.35	$611.79	$2,420.73
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.22 / $155.52 / $422.21	Professional	26	$95.22	$155.52	$422.21
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $266.14 / $498.61 / $2,048.31	Professional	TC	$266.14	$498.61	$2,048.31
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $745.12 / $953.92 / $953.92	Facility	26	$745.12	$953.92	$953.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $535.64 / $892.74 / $5,981.06	Professional		$535.64	$892.74	$5,981.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $109.10 / $175.54 / $672.78	Professional	26	$109.10	$175.54	$672.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $409.45 / $658.54 / $5,438.76	Professional	TC	$409.45	$658.54	$5,438.76
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $332.51 / $342.20 / $565.91	Facility	26	$332.51	$342.20	$565.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $788.71 / $1,010.92 / $1,557.00	Professional		$788.71	$1,010.92	$1,557.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $105.34 / $386.74 / $726.52	Professional		$105.34	$386.74	$726.52
United Facility/Professional Professional Modifier Low / Median / High Price $491.01 / $781.15 / $1,389.91	Professional		$491.01	$781.15	$1,389.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.31 / $153.60 / $313.24	Professional	26	$108.31	$153.60	$313.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $376.78 / $597.12 / $1,069.19	Professional	TC	$376.78	$597.12	$1,069.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $730.99 / $925.30 / $1,088.59	Professional		$730.99	$925.30	$1,088.59
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $179.41 / $227.10 / $267.10	Professional	26	$179.41	$227.10	$267.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $551.66 / $698.30 / $821.50	Professional	TC	$551.66	$698.30	$821.50