Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.03 / $128.21 / $329.79	Facility	26	$59.03	$128.21	$329.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $230.37 / $471.25 / $1,959.85	Professional		$230.37	$471.25	$1,959.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $131.71 / $322.79	Professional	26	$62.50	$131.71	$322.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.74 / $335.00 / $596.05	Professional	TC	$170.74	$335.00	$596.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $202.76 / $208.84 / $214.93	Facility	26	$202.76	$208.84	$214.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $367.96 / $615.91 / $1,183.23	Professional		$367.96	$615.91	$1,183.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.48 / $145.06 / $216.69	Professional	26	$67.48	$145.06	$216.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.82 / $455.51 / $1,018.06	Professional	TC	$275.82	$455.51	$1,018.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $197.51 / $338.85 / $1,409.94	Professional		$197.51	$338.85	$1,409.94
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.34 / $97.40 / $207.54	Professional	26	$59.34	$97.40	$207.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.16 / $242.69 / $1,230.76	Professional	TC	$138.16	$242.69	$1,230.76
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $463.68 / $596.96 / $596.96	Facility	26	$463.68	$596.96	$596.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $288.54 / $481.78 / $2,789.74	Professional		$288.54	$481.78	$2,789.74
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $68.25 / $112.22 / $531.65	Professional	26	$68.25	$112.22	$531.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $209.33 / $348.88 / $2,459.04	Professional	TC	$209.33	$348.88	$2,459.04
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $208.84 / $214.93 / $354.06	Facility	26	$208.84	$214.93	$354.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $435.19 / $613.15 / $872.17	Professional		$435.19	$613.15	$872.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.60 / $208.89 / $369.23	Professional		$63.60	$208.89	$369.23
United Facility/Professional Professional Modifier Low / Median / High Price $261.64 / $420.79 / $748.23	Professional		$261.64	$420.79	$748.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.25 / $99.02 / $195.97	Professional	26	$68.25	$99.02	$195.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $191.88 / $305.27 / $546.61	Professional	TC	$191.88	$305.27	$546.61
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $398.16 / $504.00 / $592.90	Professional		$398.16	$504.00	$592.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $111.71 / $141.40 / $166.40	Professional	26	$111.71	$141.40	$166.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $286.38 / $362.50 / $426.50	Professional	TC	$286.38	$362.50	$426.50