Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $229.09 / $416.87	Facility		$58.88	$229.09	$416.87
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $11.22 / $16.60	Facility	26	$7.08	$11.22	$16.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.44 / $173.78 / $549.54	Facility	TC	$23.44	$173.78	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $41.69 / $158.49	Professional		$7.94	$41.69	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $14.79 / $58.88	Professional	26	$7.24	$14.79	$58.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $18.62 / $85.11 / $245.47	Professional	50	$18.62	$85.11	$245.47
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $29.51 / $107.15 / $208.93	Professional	52	$29.51	$107.15	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $39.81 / $134.90	Professional	TC	$21.88	$39.81	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $102.33 / $104.71	Facility		$97.72	$102.33	$104.71
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 $72.44 / $75.86 / $77.62	Facility	TC	$72.44	$75.86	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $81.28 / $102.33	Professional		$40.74	$81.28	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $18.20 / $22.91	Professional	26	$10.23	$18.20	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $63.10 / $77.62	Professional	TC	$30.20	$63.10	$77.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $46.77 / $112.20	Professional		$30.20	$46.77	$112.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.30 / $34.67	Professional	26	$7.59	$12.30	$34.67
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $33.11 / $57.54	Professional	TC	$22.39	$33.11	$57.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $123.03 / $338.84	Facility		$51.29	$123.03	$338.84
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 $117.49 / $117.49 / $158.49	Facility	TC	$117.49	$117.49	$158.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $54.95 / $223.87	Professional		$28.84	$54.95	$223.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.13 / $70.79	Professional	26	$8.71	$14.13	$70.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.20 / $169.82	Professional	TC	$20.89	$30.20	$169.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $72.44 / $112.20	Professional		$60.26	$72.44	$112.20
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $19.50 / $26.92	Professional	26	$16.22	$19.50	$26.92
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $54.95 / $85.11	Professional	TC	$41.69	$54.95	$85.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
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 $77.62 / $77.62 / $77.62	Facility	TC	$77.62	$77.62	$77.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $64.57 / $87.10	Professional		$56.23	$64.57	$87.10
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $18.62 / $25.12	Professional	26	$16.22	$18.62	$25.12
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $47.86 / $66.07	Professional	TC	$38.90	$47.86	$66.07
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $512.86 / $1,445.44	Facility		$91.20	$512.86	$1,445.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $26.92 / $57.54	Professional		$8.32	$26.92	$57.54
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 $28.84 / $38.02 / $70.79	Professional		$28.84	$38.02	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.23 / $19.05	Professional	26	$8.32	$10.23	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $27.54 / $52.48	Professional	TC	$20.89	$27.54	$52.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $69.18	Professional		$57.54	$57.54	$69.18
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $13.80 / $16.22	Professional	26	$13.80	$13.80	$16.22
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $52.48	Professional	TC	$44.67	$44.67	$52.48