Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.06 / $154.47 / $398.62	Facility	26	$91.06	$154.47	$398.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $322.22 / $475.00 / $1,801.58	Professional		$322.22	$475.00	$1,801.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.86 / $125.67 / $370.49	Professional	26	$74.86	$125.67	$370.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $241.83 / $335.00 / $557.00	Professional	TC	$241.83	$335.00	$557.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $242.00 / $249.26 / $256.52	Facility	26	$242.00	$249.26	$256.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $415.99 / $767.15 / $1,238.76	Professional		$415.99	$767.15	$1,238.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $175.31 / $243.82	Professional	26	$81.28	$175.31	$243.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $350.95 / $635.89 / $1,039.42	Professional	TC	$350.95	$635.89	$1,039.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $274.64 / $472.62 / $1,581.11	Professional		$274.64	$472.62	$1,581.11
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.48 / $117.41 / $254.99	Professional	26	$71.48	$117.41	$254.99
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $203.15 / $356.84 / $1,340.59	Professional	TC	$203.15	$356.84	$1,340.59
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $558.79 / $723.52 / $723.52	Facility	26	$558.79	$723.52	$723.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $408.42 / $672.47 / $3,348.15	Professional		$408.42	$672.47	$3,348.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $81.94 / $135.68 / $586.14	Professional	26	$81.94	$135.68	$586.14
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $312.52 / $455.94 / $2,941.88	Professional	TC	$312.52	$455.94	$2,941.88
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $249.26 / $256.52 / $429.36	Facility	26	$249.26	$256.52	$429.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $602.65 / $781.74 / $1,165.57	Professional		$602.65	$781.74	$1,165.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.08 / $322.76 / $554.42	Professional		$79.08	$322.76	$554.42
United Facility/Professional Professional Modifier Low / Median / High Price $371.36 / $519.90 / $1,058.00	Professional		$371.36	$519.90	$1,058.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.94 / $119.72 / $239.43	Professional	26	$81.94	$119.72	$239.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $286.58 / $390.81 / $814.14	Professional	TC	$286.58	$390.81	$814.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $555.77 / $703.50 / $827.60	Professional		$555.77	$703.50	$827.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $134.69 / $170.50 / $200.60	Professional	26	$134.69	$170.50	$200.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $421.07 / $533.00 / $627.10	Professional	TC	$421.07	$533.00	$627.10