Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.94 / $225.90 / $382.50	Facility		$56.94	$225.90	$382.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.21 / $13.71 / $41.22	Facility	26	$7.21	$13.71	$41.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $37.14 / $237.16 / $551.50	Facility	TC	$37.14	$237.16	$551.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.92 / $37.00 / $131.96	Professional		$7.92	$37.00	$131.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $10.88 / $43.37	Professional	26	$7.33	$10.88	$43.37
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2.74 / $63.92 / $124.40	Professional	50	$2.74	$63.92	$124.40
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.70 / $15.97 / $21.83	Professional	52	$13.70	$15.97	$21.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.20 / $30.98 / $73.87	Professional	TC	$22.20	$30.98	$73.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $98.24 / $101.19 / $104.13	Facility		$98.24	$101.19	$104.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.05 / $25.80 / $26.55	Facility	26	$25.05	$25.80	$26.55
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $73.19 / $75.39 / $77.58	Facility	TC	$73.19	$75.39	$77.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.72 / $79.12 / $101.35	Professional		$33.72	$79.12	$101.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $17.84 / $25.00	Professional	26	$8.56	$17.84	$25.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.74 / $61.28 / $76.59	Professional	TC	$23.74	$61.28	$76.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $29.63 / $46.22 / $77.54	Professional		$29.63	$46.22	$77.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $11.58 / $27.68	Professional	26	$7.50	$11.58	$27.68
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.14 / $32.78 / $44.41	Professional	TC	$22.14	$32.78	$44.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.06 / $83.19 / $243.87	Facility		$47.06	$83.19	$243.87
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.80 / $100.00 / $100.00	Facility	26	$25.80	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $75.39 / $118.08 / $156.72	Facility	TC	$75.39	$118.08	$156.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.34 / $49.45 / $221.82	Professional		$30.34	$49.45	$221.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $11.57 / $71.00	Professional	26	$8.52	$11.57	$71.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.77 / $29.18 / $170.86	Professional	TC	$21.77	$29.18	$170.86
Midlands Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $72.58 / $115.47	Facility		$55.00	$72.58	$115.47
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $25.80 / $26.55 / $44.82	Facility	26	$25.80	$26.55	$44.82
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $75.39 / $77.58 / $141.12	Facility	TC	$75.39	$77.58	$141.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $66.69 / $101.35	Professional		$50.00	$66.69	$101.35
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $84.06 / $724.08 / $1,474.03	Facility		$84.06	$724.08	$1,474.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.07 / $27.00 / $57.17	Professional		$8.07	$27.00	$57.17
United Facility/Professional Facility Modifier Low / Median / High Price $107.74 / $109.22 / $161.80	Facility		$107.74	$109.22	$161.80
United Facility/Professional Professional Modifier Low / Median / High Price $30.34 / $39.51 / $74.97	Professional		$30.34	$39.51	$74.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.25 / $10.39 / $17.30	Professional	26	$8.25	$10.39	$17.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.09 / $27.04 / $48.40	Professional	TC	$22.09	$27.04	$48.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $45.98 / $58.20 / $68.50	Professional		$45.98	$58.20	$68.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $10.82 / $13.70 / $16.10	Professional	26	$10.82	$13.70	$16.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $35.15 / $44.50 / $52.40	Professional	TC	$35.15	$44.50	$52.40