Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $223.87 / $457.09	Facility		$63.10	$223.87	$457.09
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $9.12 / $18.62	Facility	26	$7.94	$9.12	$18.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $194.98 / $354.81	Facility	TC	$30.20	$194.98	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $46.77 / $208.93	Professional		$9.12	$46.77	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $16.98 / $54.95	Professional	26	$8.32	$16.98	$54.95
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.95 / $85.11 / $251.19	Professional	50	$19.95	$85.11	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $44.67 / $169.82	Professional	TC	$25.70	$44.67	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $120.23 / $123.03	Facility		$114.82	$120.23	$123.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $30.90 / $32.36	Facility	26	$30.20	$30.90	$32.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $85.11 / $87.10 / $91.20	Facility	TC	$85.11	$87.10	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $97.72 / $120.23	Professional		$47.86	$97.72	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $20.42 / $25.70	Professional	26	$11.22	$20.42	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $75.86 / $95.50	Professional	TC	$33.88	$75.86	$95.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $54.95 / $138.04	Professional		$36.31	$54.95	$138.04
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $13.80 / $45.71	Professional	26	$8.32	$13.80	$45.71
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $41.69 / $93.33	Professional	TC	$28.18	$41.69	$93.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $123.03 / $346.74	Facility		$58.88	$123.03	$346.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $100.00 / $100.00	Facility	26	$30.90	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $93.33 / $144.54 / $158.49	Facility	TC	$93.33	$144.54	$158.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $64.57 / $263.03	Professional		$35.48	$64.57	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.14 / $79.43	Professional	26	$9.33	$15.14	$79.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $38.02 / $204.17	Professional	TC	$25.70	$38.02	$204.17
Midlands Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $83.18 / $102.33	Professional		$66.07	$83.18	$102.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $21.88 / $22.91	Professional	26	$17.78	$21.88	$22.91
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $61.66 / $79.43	Professional	TC	$47.86	$61.66	$79.43
Midlands Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $32.36 / $32.36	Facility	26	$32.36	$32.36	$32.36
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $91.20 / $91.20 / $91.20	Facility	TC	$91.20	$91.20	$91.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $77.62 / $102.33	Professional		$69.18	$77.62	$102.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $20.89 / $28.18	Professional	26	$18.20	$20.89	$28.18
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $57.54 / $79.43	Professional	TC	$50.12	$57.54	$79.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $33.88 / $72.44	Professional		$9.77	$33.88	$72.44
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 $33.88 / $45.71 / $85.11	Professional		$33.88	$45.71	$85.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $11.48 / $21.38	Professional	26	$9.33	$11.48	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.11 / $63.10	Professional	TC	$25.70	$33.11	$63.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $81.28	Professional		$69.18	$69.18	$81.28
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $15.49 / $18.20	Professional	26	$15.49	$15.49	$18.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $53.70 / $63.10	Professional	TC	$53.70	$53.70	$63.10