Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.77 / $248.62 / $459.16	Facility	26	$122.77	$248.62	$459.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $310.19 / $475.00 / $1,036.99	Professional		$310.19	$475.00	$1,036.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.91 / $123.56 / $372.00	Professional	26	$77.91	$123.56	$372.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $242.49 / $335.00 / $557.00	Professional	TC	$242.49	$335.00	$557.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $245.04 / $252.39 / $259.74	Facility	26	$245.04	$252.39	$259.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $425.54 / $772.29 / $1,267.23	Professional		$425.54	$772.29	$1,267.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $175.31 / $240.92	Professional	26	$81.28	$175.31	$240.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $357.79 / $594.48 / $1,066.47	Professional	TC	$357.79	$594.48	$1,066.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $276.06 / $475.11 / $1,587.06	Professional		$276.06	$475.11	$1,587.06
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.48 / $117.41 / $360.77	Professional	26	$71.48	$117.41	$360.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $204.57 / $359.33 / $1,349.27	Professional	TC	$204.57	$359.33	$1,349.27
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $558.79 / $720.40 / $720.40	Facility	26	$558.79	$720.40	$720.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $409.20 / $676.04 / $3,348.15	Professional		$409.20	$676.04	$3,348.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $82.27 / $133.97 / $597.70	Professional	26	$82.27	$133.97	$597.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $313.43 / $457.78 / $2,941.88	Professional	TC	$313.43	$457.78	$2,941.88
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $252.39 / $259.74 / $427.56	Facility	26	$252.39	$259.74	$427.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $603.27 / $773.29 / $1,075.52	Professional		$603.27	$773.29	$1,075.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $76.63 / $294.55 / $519.04	Professional		$76.63	$294.55	$519.04
United Facility/Professional Professional Modifier Low / Median / High Price $364.75 / $511.50 / $1,062.98	Professional		$364.75	$511.50	$1,062.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.58 / $111.90 / $207.20	Professional	26	$81.58	$111.90	$207.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $274.25 / $403.69 / $819.13	Professional	TC	$274.25	$403.69	$819.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $558.69 / $707.20 / $832.00	Professional		$558.69	$707.20	$832.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $134.69 / $170.50 / $200.60	Professional	26	$134.69	$170.50	$200.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $423.99 / $536.70 / $631.50	Professional	TC	$423.99	$536.70	$631.50