Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.02 / $183.89 / $340.24	Facility	26	$118.02	$183.89	$340.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.32 / $272.17 / $423.42	Professional		$195.32	$272.17	$423.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $57.16 / $87.10	Professional	26	$52.78	$57.16	$87.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $137.32 / $190.29 / $347.46	Professional	TC	$137.32	$190.29	$347.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $182.24 / $187.71 / $193.17	Facility	26	$182.24	$187.71	$193.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.32 / $470.64 / $915.54	Professional		$291.32	$470.64	$915.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.36 / $130.32 / $178.44	Professional	26	$60.36	$130.32	$178.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.38 / $337.48 / $766.03	Professional	TC	$210.38	$337.48	$766.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $173.44 / $321.85 / $1,040.44	Professional		$173.44	$321.85	$1,040.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.14 / $85.85 / $273.05	Professional	26	$53.14	$85.85	$273.05
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $120.30 / $226.11 / $768.50	Professional	TC	$120.30	$226.11	$768.50
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $414.72 / $537.20 / $537.20	Facility	26	$414.72	$537.20	$537.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $240.84 / $422.52 / $2,082.64	Professional		$240.84	$422.52	$2,082.64
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $60.54 / $77.29 / $381.41	Professional	26	$60.54	$77.29	$381.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $174.07 / $279.49 / $1,754.89	Professional	TC	$174.07	$279.49	$1,754.89
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $187.71 / $193.17 / $318.95	Facility	26	$187.71	$193.17	$318.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $375.27 / $531.83 / $700.00	Professional		$375.27	$531.83	$700.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.05 / $183.20 / $324.12	Professional		$57.05	$183.20	$324.12
United Facility/Professional Professional Modifier Low / Median / High Price $236.75 / $284.10 / $502.57	Professional		$236.75	$284.10	$502.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.54 / $77.29 / $171.87	Professional	26	$60.54	$77.29	$171.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $174.07 / $206.07 / $366.17	Professional	TC	$174.07	$206.07	$366.17
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $301.14 / $381.20 / $448.50	Professional		$301.14	$381.20	$448.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $86.19 / $109.10 / $128.30	Professional	26	$86.19	$109.10	$128.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $214.96 / $272.10 / $320.10	Professional	TC	$214.96	$272.10	$320.10