Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.05 / $125.05 / $342.76	Facility	26	$125.05	$125.05	$342.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.79 / $324.24 / $1,321.00	Professional		$234.79	$324.24	$1,321.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.39 / $67.20 / $163.04	Professional	26	$60.39	$67.20	$163.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.97 / $230.00 / $519.24	Professional	TC	$168.97	$230.00	$519.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $211.80 / $218.15 / $224.51	Facility	26	$211.80	$218.15	$224.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $353.15 / $619.78 / $1,052.23	Professional		$353.15	$619.78	$1,052.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.61 / $149.71 / $205.56	Professional	26	$69.61	$149.71	$205.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $294.33 / $470.07 / $879.94	Professional	TC	$294.33	$470.07	$879.94
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $229.49 / $426.74 / $1,065.89	Professional		$229.49	$426.74	$1,065.89
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.24 / $99.09 / $207.13	Professional	26	$61.24	$99.09	$207.13
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $168.24 / $316.44 / $877.45	Professional	TC	$168.24	$316.44	$877.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $478.24 / $619.20 / $619.20	Facility	26	$478.24	$619.20	$619.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $285.89 / $501.63 / $2,385.40	Professional		$285.89	$501.63	$2,385.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $68.44 / $89.12 / $533.30	Professional	26	$68.44	$89.12	$533.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $210.62 / $326.67 / $2,603.00	Professional	TC	$210.62	$326.67	$2,603.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $218.15 / $224.51 / $367.50	Facility	26	$218.15	$224.51	$367.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $456.27 / $551.91 / $844.57	Professional		$456.27	$551.91	$844.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.06 / $201.35 / $437.50	Professional		$66.06	$201.35	$437.50
United Facility/Professional Professional Modifier Low / Median / High Price $259.91 / $338.45 / $592.59	Professional		$259.91	$338.45	$592.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.44 / $82.13 / $155.13	Professional	26	$68.44	$82.13	$155.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $210.62 / $253.78 / $436.55	Professional	TC	$210.62	$253.78	$436.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $399.98 / $506.30 / $595.70	Professional		$399.98	$506.30	$595.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $99.38 / $125.80 / $148.00	Professional	26	$99.38	$125.80	$148.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $300.67 / $380.60 / $447.70	Professional	TC	$300.67	$380.60	$447.70