Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $204.74 / $204.74 / $527.46	Facility	26	$204.74	$204.74	$527.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.87 / $475.00 / $2,057.90	Professional		$398.87	$475.00	$2,057.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.30 / $140.00 / $473.51	Professional	26	$98.30	$140.00	$473.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $292.27 / $335.00 / $922.11	Professional	TC	$292.27	$335.00	$922.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $318.48 / $328.03 / $337.59	Facility	26	$318.48	$328.03	$337.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $533.36 / $955.18 / $1,589.02	Professional		$533.36	$955.18	$1,589.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.69 / $231.93 / $322.58	Professional	26	$108.69	$231.93	$322.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $429.32 / $720.64 / $1,325.62	Professional	TC	$429.32	$720.64	$1,325.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $340.63 / $586.30 / $2,349.23	Professional		$340.63	$586.30	$2,349.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.22 / $155.68 / $509.92	Professional	26	$95.22	$155.68	$509.92
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $245.42 / $430.80 / $2,063.88	Professional	TC	$245.42	$430.80	$2,063.88
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $745.12 / $957.12 / $957.12	Facility	26	$745.12	$957.12	$957.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $506.00 / $843.34 / $5,981.06	Professional		$506.00	$843.34	$5,981.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $108.76 / $178.77 / $894.00	Professional	26	$108.76	$178.77	$894.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $379.81 / $610.86 / $5,438.76	Professional	TC	$379.81	$610.86	$5,438.76
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $328.03 / $337.59 / $567.72	Facility	26	$328.03	$337.59	$567.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $745.41 / $955.18 / $1,557.00	Professional		$745.41	$955.18	$1,557.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $105.34 / $386.74 / $686.93	Professional		$105.34	$386.74	$686.93
United Facility/Professional Professional Modifier Low / Median / High Price $463.84 / $716.84 / $1,313.87	Professional		$463.84	$716.84	$1,313.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.28 / $157.74 / $312.27	Professional	26	$107.28	$157.74	$312.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $349.35 / $553.89 / $915.85	Professional	TC	$349.35	$553.89	$915.85
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $688.09 / $871.00 / $1,024.70	Professional		$688.09	$871.00	$1,024.70
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 $508.68 / $643.90 / $757.60	Professional	TC	$508.68	$643.90	$757.60