Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.81 / $195.87 / $536.82	Facility	26	$95.81	$195.87	$536.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $512.36 / $2,287.71	Professional		$275.00	$512.36	$2,287.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.25 / $114.18 / $529.00	Professional	26	$91.25	$114.18	$529.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.00 / $386.69 / $559.71	Professional	TC	$220.00	$386.69	$559.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $320.49 / $330.10 / $339.72	Facility	26	$320.49	$330.10	$339.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $473.17 / $906.02 / $1,409.62	Professional		$473.17	$906.02	$1,409.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.65 / $235.04 / $326.89	Professional	26	$110.65	$235.04	$326.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $386.67 / $670.98 / $1,146.20	Professional	TC	$386.67	$670.98	$1,146.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $337.17 / $503.35 / $1,500.43	Professional		$337.17	$503.35	$1,500.43
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $96.84 / $139.44 / $394.16	Professional	26	$96.84	$139.44	$394.16
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $240.32 / $366.03 / $916.39	Professional	TC	$240.32	$366.03	$916.39
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $757.60 / $969.20 / $969.20	Facility	26	$757.60	$969.20	$969.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $415.91 / $699.41 / $2,573.48	Professional		$415.91	$699.41	$2,573.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $106.94 / $139.26 / $653.20	Professional	26	$106.94	$139.26	$653.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $298.27 / $419.36 / $2,038.19	Professional	TC	$298.27	$419.36	$2,038.19
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $330.10 / $339.72 / $574.50	Facility	26	$330.10	$339.72	$574.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $715.46 / $823.35 / $1,309.88	Professional		$715.46	$823.35	$1,309.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.31 / $355.45 / $632.17	Professional		$104.31	$355.45	$632.17
United Facility/Professional Professional Modifier Low / Median / High Price $409.29 / $524.82 / $1,717.05	Professional		$409.29	$524.82	$1,717.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.30 / $128.33 / $241.62	Professional	26	$107.30	$128.33	$241.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $284.56 / $353.10 / $601.97	Professional	TC	$284.56	$353.10	$601.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $586.58 / $742.50 / $873.50	Professional		$586.58	$742.50	$873.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $157.13 / $198.90 / $234.10	Professional	26	$157.13	$198.90	$234.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $429.44 / $543.60 / $639.50	Professional	TC	$429.44	$543.60	$639.50