Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $125.89 / $346.74	Facility		$29.51	$125.89	$346.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $7.59 / $16.98	Facility	26	$7.08	$7.59	$16.98
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.89 / $61.66 / $134.90	Facility	TC	$20.89	$61.66	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $39.81 / $147.91	Professional		$15.85	$39.81	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.79 / $46.77	Professional	26	$7.08	$14.79	$46.77
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.11 / $74.13 / $158.49	Professional	50	$33.11	$74.13	$158.49
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $19.05 / $47.86 / $158.49	Professional	52	$19.05	$47.86	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $29.51 / $112.20	Professional	TC	$19.05	$29.51	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $93.33 / $95.50	Facility		$89.13	$93.33	$95.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $25.70 / $26.30	Facility	26	$25.12	$25.70	$26.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $64.57 / $67.61 / $69.18	Facility	TC	$64.57	$67.61	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $75.86 / $95.50	Professional		$36.31	$75.86	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $17.38 / $21.88	Professional	26	$9.77	$17.38	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $58.88 / $74.13	Professional	TC	$26.30	$58.88	$74.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $43.65 / $102.33	Professional		$28.84	$43.65	$102.33
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $11.75 / $39.81	Professional	26	$7.24	$11.75	$39.81
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $31.62 / $48.98	Professional	TC	$21.88	$31.62	$48.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $70.79 / $346.74	Facility		$43.65	$70.79	$346.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $100.00 / $100.00	Facility	26	$25.70	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $67.61 / $109.65 / $109.65	Facility	TC	$67.61	$109.65	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $51.29 / $208.93	Professional		$28.84	$51.29	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $12.30 / $67.61	Professional	26	$8.13	$12.30	$67.61
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.90 / $158.49	Professional	TC	$19.95	$30.90	$158.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $67.61 / $81.28	Professional		$53.70	$67.61	$81.28
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $17.78 / $22.39	Professional	26	$15.49	$17.78	$22.39
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $48.98 / $61.66	Professional	TC	$38.90	$48.98	$61.66
Midlands Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $26.30 / $26.30	Facility	26	$26.30	$26.30	$26.30
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $69.18 / $69.18 / $69.18	Facility	TC	$69.18	$69.18	$69.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $58.88 / $81.28	Professional		$57.54	$58.88	$81.28
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $18.20 / $22.91	Professional	26	$15.49	$18.20	$22.91
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $42.66 / $61.66	Professional	TC	$40.74	$42.66	$61.66
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $25.12 / $54.95	Professional		$8.32	$25.12	$54.95
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 $27.54 / $36.31 / $67.61	Professional		$27.54	$36.31	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.23 / $17.78	Professional	26	$8.13	$10.23	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $26.30 / $46.77	Professional	TC	$19.95	$26.30	$46.77
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $64.57	Professional		$54.95	$54.95	$64.57
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 $41.69 / $41.69 / $48.98	Professional	TC	$41.69	$41.69	$48.98