Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.65 / $170.41 / $441.95	Facility	26	$78.65	$170.41	$441.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $342.85 / $475.00 / $702.84	Professional		$342.85	$475.00	$702.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $126.00 / $143.00	Professional	26	$85.00	$126.00	$143.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $256.94 / $335.00 / $484.30	Professional	TC	$256.94	$335.00	$484.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $268.83 / $276.89 / $284.95	Facility	26	$268.83	$276.89	$284.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $441.02 / $814.06 / $1,314.22	Professional		$441.02	$814.06	$1,314.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.61 / $193.15 / $264.77	Professional	26	$90.61	$193.15	$264.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $368.52 / $618.29 / $1,092.09	Professional	TC	$368.52	$618.29	$1,092.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $298.17 / $553.42 / $1,440.45	Professional		$298.17	$553.42	$1,440.45
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.41 / $129.50 / $332.19	Professional	26	$79.41	$129.50	$332.19
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $218.76 / $411.05 / $1,160.11	Professional	TC	$218.76	$411.05	$1,160.11
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $620.48 / $795.52 / $795.52	Facility	26	$620.48	$795.52	$795.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $396.17 / $673.32 / $3,018.44	Professional		$396.17	$673.32	$3,018.44
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $88.01 / $114.61 / $850.86	Professional	26	$88.01	$114.61	$850.86
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $293.08 / $420.87 / $2,546.60	Professional	TC	$293.08	$420.87	$2,546.60
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $276.89 / $284.95 / $471.66	Facility	26	$276.89	$284.95	$471.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $645.21 / $816.64 / $1,160.43	Professional		$645.21	$816.64	$1,160.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.33 / $305.76 / $564.22	Professional		$85.33	$305.76	$564.22
United Facility/Professional Professional Modifier Low / Median / High Price $360.15 / $468.99 / $955.79	Professional		$360.15	$468.99	$955.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.01 / $105.61 / $220.03	Professional	26	$88.01	$105.61	$220.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $272.14 / $354.38 / $711.78	Professional	TC	$272.14	$354.38	$711.78
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 $149.38 / $189.10 / $222.50	Professional	26	$149.38	$189.10	$222.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $453.46 / $574.00 / $675.20	Professional	TC	$453.46	$574.00	$675.20