Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $173.78 / $436.52	Facility		$52.48	$173.78	$436.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $11.48 / $16.60	Facility	26	$6.03	$11.48	$16.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.42 / $58.88 / $316.23	Facility	TC	$20.42	$58.88	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $37.15 / $147.91	Professional		$8.91	$37.15	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.45 / $45.71	Professional	26	$7.08	$14.45	$45.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.60 / $64.57 / $151.36	Professional	50	$16.60	$64.57	$151.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $32.36 / $104.71	Professional	TC	$19.05	$32.36	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $89.13 / $91.20	Facility		$87.10	$89.13	$91.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $26.92 / $27.54	Facility	26	$25.70	$26.92	$27.54
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $60.26 / $61.66 / $64.57	Facility	TC	$60.26	$61.66	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $75.86 / $93.33	Professional		$35.48	$75.86	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $17.38 / $21.88	Professional	26	$10.00	$17.38	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $57.54 / $72.44	Professional	TC	$24.55	$57.54	$72.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $45.71 / $112.20	Professional		$28.18	$45.71	$112.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $12.88 / $40.74	Professional	26	$7.24	$12.88	$40.74
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $31.62 / $72.44	Professional	TC	$21.38	$31.62	$72.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $79.43 / $977.24	Facility		$42.66	$79.43	$977.24
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $100.00 / $100.00	Facility	26	$26.92	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $61.66 / $109.65 / $181.97	Facility	TC	$61.66	$109.65	$181.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $52.48 / $204.17	Professional		$28.18	$52.48	$204.17
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.88 / $75.86	Professional	26	$8.71	$12.88	$75.86
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $29.51 / $162.18	Professional	TC	$19.50	$29.51	$162.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $67.61 / $102.33	Professional		$57.54	$67.61	$102.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $18.62 / $26.30	Professional	26	$15.49	$18.62	$26.30
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $51.29 / $77.62	Professional	TC	$39.81	$51.29	$77.62
Midlands Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $27.54 / $27.54	Facility	26	$27.54	$27.54	$27.54
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $64.57 / $64.57 / $64.57	Facility	TC	$64.57	$64.57	$64.57
Midlands Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $56.23 / $79.43	Professional		$23.99	$56.23	$79.43
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $17.78 / $23.99	Professional	26	$16.60	$17.78	$23.99
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $39.81 / $60.26	Professional	TC	$38.02	$39.81	$60.26
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $5,011.87 / $10,000.00	Facility		$660.69	$5,011.87	$10,000.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $24.55 / $53.70	Professional		$7.94	$24.55	$53.70
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 $26.92 / $35.48 / $66.07	Professional		$26.92	$35.48	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.77 / $18.20	Professional	26	$7.94	$9.77	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $25.12 / $46.77	Professional	TC	$19.50	$25.12	$46.77
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $63.10	Professional		$53.70	$53.70	$63.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $13.18 / $15.49	Professional	26	$13.18	$13.18	$15.49
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $40.74 / $47.86	Professional	TC	$40.74	$40.74	$47.86