Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $165.42 / $204.09 / $527.46	Facility	26	$165.42	$204.09	$527.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $378.36 / $475.00 / $2,001.85	Professional		$378.36	$475.00	$2,001.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.99 / $140.00 / $503.87	Professional	26	$97.99	$140.00	$503.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $290.95 / $335.00 / $599.77	Professional	TC	$290.95	$335.00	$599.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $321.32 / $330.96 / $340.60	Facility	26	$321.32	$330.96	$340.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $533.94 / $952.09 / $1,590.45	Professional		$533.94	$952.09	$1,590.45
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 $427.83 / $718.33 / $1,328.46	Professional	TC	$427.83	$718.33	$1,328.46
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $339.78 / $584.82 / $2,349.23	Professional		$339.78	$584.82	$2,349.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.22 / $155.68 / $512.79	Professional	26	$95.22	$155.68	$512.79
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $244.57 / $429.32 / $2,062.92	Professional	TC	$244.57	$429.32	$2,062.92
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $745.12 / $953.92 / $953.92	Facility	26	$745.12	$953.92	$953.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $505.21 / $842.02 / $5,981.06	Professional		$505.21	$842.02	$5,981.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $109.10 / $175.54 / $883.52	Professional	26	$109.10	$175.54	$883.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $379.02 / $609.59 / $5,438.76	Professional	TC	$379.02	$609.59	$5,438.76
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $330.96 / $340.60 / $565.91	Facility	26	$330.96	$340.60	$565.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $742.32 / $952.09 / $1,557.00	Professional		$742.32	$952.09	$1,557.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $102.51 / $357.61 / $636.23	Professional		$102.51	$357.61	$636.23
United Facility/Professional Professional Modifier Low / Median / High Price $458.34 / $631.77 / $1,310.87	Professional		$458.34	$631.77	$1,310.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $105.27 / $157.74 / $320.72	Professional	26	$105.27	$157.74	$320.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $344.71 / $493.11 / $990.15	Professional	TC	$344.71	$493.11	$990.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $686.27 / $868.70 / $1,022.10	Professional		$686.27	$868.70	$1,022.10
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 $506.94 / $641.70 / $754.90	Professional	TC	$506.94	$641.70	$754.90