Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $163.03 / $204.09 / $527.46	Facility	26	$163.03	$204.09	$527.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $322.00 / $475.00 / $2,574.26	Professional		$322.00	$475.00	$2,574.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.93 / $140.00 / $472.56	Professional	26	$97.93	$140.00	$472.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $242.16 / $335.00 / $494.98	Professional	TC	$242.16	$335.00	$494.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $317.42 / $326.94 / $336.47	Facility	26	$317.42	$326.94	$336.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $556.78 / $968.81 / $1,690.12	Professional		$556.78	$968.81	$1,690.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.69 / $231.93 / $322.58	Professional	26	$108.69	$231.93	$322.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $395.93 / $713.64 / $1,428.13	Professional	TC	$395.93	$713.64	$1,428.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $299.50 / $554.84 / $2,416.88	Professional		$299.50	$554.84	$2,416.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.22 / $155.52 / $315.99	Professional	26	$95.22	$155.52	$315.99
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $204.28 / $384.06 / $2,131.52	Professional	TC	$204.28	$384.06	$2,131.52
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $745.12 / $950.80 / $950.80	Facility	26	$745.12	$950.80	$950.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $437.66 / $772.94 / $5,978.92	Professional		$437.66	$772.94	$5,978.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $109.10 / $180.36 / $733.09	Professional	26	$109.10	$180.36	$733.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $311.85 / $519.76 / $5,438.76	Professional	TC	$311.85	$519.76	$5,438.76
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $326.94 / $336.47 / $564.05	Facility	26	$326.94	$336.47	$564.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $649.54 / $961.51 / $1,557.00	Professional		$649.54	$961.51	$1,557.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $102.51 / $315.22 / $560.97	Professional		$102.51	$315.22	$560.97
United Facility/Professional Professional Modifier Low / Median / High Price $389.75 / $547.07 / $1,135.83	Professional		$389.75	$547.07	$1,135.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.97 / $157.25 / $364.37	Professional	26	$107.97	$157.25	$364.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $279.70 / $426.20 / $891.69	Professional	TC	$279.70	$426.20	$891.69
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $602.77 / $763.00 / $897.70	Professional		$602.77	$763.00	$897.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $179.41 / $227.10 / $267.10	Professional	26	$179.41	$227.10	$267.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $423.44 / $536.00 / $630.60	Professional	TC	$423.44	$536.00	$630.60