Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $229.09 / $467.74	Facility		$60.26	$229.09	$467.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $11.48 / $16.98	Facility	26	$7.08	$11.48	$16.98
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.30 / $162.18 / $549.54	Facility	TC	$26.30	$162.18	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $41.69 / $165.96	Professional		$9.33	$41.69	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $16.22 / $52.48	Professional	26	$7.76	$16.22	$52.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $91.20 / $213.80	Professional	50	$34.67	$91.20	$213.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $29.51 / $60.26 / $125.89	Professional	52	$29.51	$60.26	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $40.74 / $131.83	Professional	TC	$22.91	$40.74	$131.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $107.15 / $109.65	Facility		$104.71	$107.15	$109.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $26.92 / $27.54	Facility	26	$26.30	$26.92	$27.54
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $77.62 / $79.43 / $81.28	Facility	TC	$77.62	$79.43	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $87.10 / $107.15	Professional		$41.69	$87.10	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $19.05 / $23.99	Professional	26	$10.72	$19.05	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $67.61 / $85.11	Professional	TC	$30.90	$67.61	$85.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $120.23	Professional		$32.36	$47.86	$120.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.88 / $39.81	Professional	26	$7.76	$12.88	$39.81
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $35.48 / $66.07	Professional	TC	$23.99	$35.48	$66.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $120.23 / $346.74	Facility		$51.29	$120.23	$346.74
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 $112.20 / $125.89 / $151.36	Facility	TC	$112.20	$125.89	$151.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $57.54 / $234.42	Professional		$30.90	$57.54	$234.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.45 / $70.79	Professional	26	$8.71	$14.45	$70.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.11 / $181.97	Professional	TC	$21.88	$33.11	$181.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $77.62 / $95.50	Professional		$61.66	$77.62	$95.50
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $20.42 / $28.18	Professional	26	$16.98	$20.42	$28.18
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $60.26 / $72.44	Professional	TC	$43.65	$60.26	$72.44
Midlands Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
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 $81.28 / $81.28 / $81.28	Facility	TC	$81.28	$81.28	$81.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $67.61 / $93.33	Professional		$61.66	$67.61	$93.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $19.50 / $25.12	Professional	26	$16.60	$19.50	$25.12
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $51.29 / $72.44	Professional	TC	$43.65	$51.29	$72.44
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $7,079.46 / $19,498.45	Facility		$1,258.93	$7,079.46	$19,498.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $29.51 / $63.10	Professional		$8.71	$29.51	$63.10
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 $30.20 / $40.74 / $75.86	Professional		$30.20	$40.74	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.72 / $19.50	Professional	26	$8.51	$10.72	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $29.51 / $57.54	Professional	TC	$22.39	$29.51	$57.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $72.44	Professional		$61.66	$61.66	$72.44
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $14.45 / $16.98	Professional	26	$14.45	$14.45	$16.98
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $47.86 / $56.23	Professional	TC	$47.86	$47.86	$56.23