Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.15 / $176.10 / $366.59	Facility		$68.15	$176.10	$366.59
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.90 / $13.10 / $26.67	Facility	26	$6.90	$13.10	$26.67
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.12 / $62.94 / $272.58	Facility	TC	$21.12	$62.94	$272.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.55 / $32.35 / $138.00	Professional		$16.55	$32.35	$138.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.90 / $9.83 / $42.49	Professional	26	$6.90	$9.83	$42.49
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.55 / $89.28 / $112.62	Professional	50	$43.55	$89.28	$112.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.55 / $24.25 / $56.28	Professional	TC	$18.55	$24.25	$56.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.31 / $88.90 / $91.49	Facility		$86.31	$88.90	$91.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.97 / $26.75 / $27.53	Facility	26	$25.97	$26.75	$27.53
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $60.35 / $62.16 / $63.97	Facility	TC	$60.35	$62.16	$63.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.95 / $73.69 / $100.05	Professional		$31.95	$73.69	$100.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.21 / $17.07 / $24.00	Professional	26	$8.21	$17.07	$24.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.32 / $56.63 / $70.78	Professional	TC	$23.32	$56.63	$70.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $27.61 / $43.17 / $88.56	Professional		$27.61	$43.17	$88.56
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.17 / $11.72 / $28.00	Professional	26	$7.17	$11.72	$28.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.44 / $30.72 / $47.20	Professional	TC	$20.44	$30.72	$47.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.20 / $65.34 / $239.94	Facility		$42.20	$65.34	$239.94
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $100.00 / $100.00	Facility	26	$26.75	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $62.16 / $109.00 / $181.41	Facility	TC	$62.16	$109.00	$181.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.34 / $47.91 / $202.34	Professional		$28.34	$47.91	$202.34
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $10.80 / $75.00	Professional	26	$8.30	$10.80	$75.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.42 / $27.29 / $163.00	Professional	TC	$19.42	$27.29	$163.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $53.00 / $67.61 / $107.56	Facility		$53.00	$67.61	$107.56
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $27.53 / $42.84	Facility	26	$26.75	$27.53	$42.84
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $62.16 / $63.97 / $128.52	Facility	TC	$62.16	$63.97	$128.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $61.48 / $100.05	Professional		$48.00	$61.48	$100.05
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $658.47 / $4,981.49 / $10,140.93	Facility		$658.47	$4,981.49	$10,140.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.85 / $28.21 / $52.76	Professional		$7.85	$28.21	$52.76
United Facility/Professional Professional Modifier Low / Median / High Price $28.34 / $34.06 / $58.94	Professional		$28.34	$34.06	$58.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.89 / $9.88 / $16.55	Professional	26	$7.89	$9.88	$16.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.45 / $25.16 / $43.87	Professional	TC	$20.45	$25.16	$43.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $42.82 / $54.20 / $63.80	Professional		$42.82	$54.20	$63.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $13.10 / $15.40	Professional	26	$10.35	$13.10	$15.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $32.47 / $41.10 / $48.40	Professional	TC	$32.47	$41.10	$48.40