Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.59 / $227.04 / $469.30	Facility		$68.59	$227.04	$469.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.10 / $15.40 / $29.35	Facility	26	$8.10	$15.40	$29.35
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $37.94 / $147.68 / $345.60	Facility	TC	$37.94	$147.68	$345.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.63 / $42.46 / $179.12	Professional		$9.63	$42.46	$179.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.24 / $11.48 / $45.75	Professional	26	$8.24	$11.48	$45.75
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.27 / $70.40 / $249.00	Professional	50	$19.27	$70.40	$249.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.14 / $18.45 / $25.80	Professional	52	$16.14	$18.45	$25.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.54 / $31.75 / $103.50	Professional	TC	$26.54	$31.75	$103.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.41 / $118.87 / $122.33	Facility		$115.41	$118.87	$122.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.18 / $31.09 / $31.99	Facility	26	$30.18	$31.09	$31.99
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $85.23 / $87.79 / $90.34	Facility	TC	$85.23	$87.79	$90.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.19 / $94.64 / $118.29	Professional		$37.19	$94.64	$118.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.58 / $20.17 / $25.74	Professional	26	$9.58	$20.17	$25.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.12 / $74.47 / $93.08	Professional	TC	$26.12	$74.47	$93.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $35.35 / $53.01 / $102.98	Professional		$35.35	$53.01	$102.98
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $13.42 / $32.00	Professional	26	$8.39	$13.42	$32.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.96 / $40.59 / $59.87	Professional	TC	$26.96	$40.59	$59.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.21 / $88.14 / $289.61	Facility		$54.21	$88.14	$289.61
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $31.09 / $100.00 / $100.00	Facility	26	$31.09	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $92.56 / $143.82 / $157.72	Facility	TC	$92.56	$143.82	$157.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.26 / $59.46 / $263.06	Professional		$36.26	$59.46	$263.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $12.51 / $79.26	Professional	26	$9.27	$12.51	$79.26
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.29 / $35.79 / $205.55	Professional	TC	$26.29	$35.79	$205.55
Midlands Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $86.66 / $138.11	Facility		$60.00	$86.66	$138.11
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $31.09 / $31.99 / $50.40	Facility	26	$31.09	$31.99	$50.40
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $87.79 / $90.34 / $171.72	Facility	TC	$87.79	$90.34	$171.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $79.62 / $110.32	Professional		$55.00	$79.62	$110.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.16 / $34.21 / $70.84	Professional		$9.16	$34.21	$70.84
United Facility/Professional Professional Modifier Low / Median / High Price $36.26 / $45.45 / $75.70	Professional		$36.26	$45.45	$75.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.26 / $11.69 / $19.48	Professional	26	$9.26	$11.69	$19.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.99 / $33.74 / $58.26	Professional	TC	$26.99	$33.74	$58.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $55.06 / $69.70 / $81.90	Professional		$55.06	$69.70	$81.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $12.17 / $15.40 / $18.10	Professional	26	$12.17	$15.40	$18.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $42.82 / $54.20 / $63.80	Professional	TC	$42.82	$54.20	$63.80