Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.28 / $126.71 / $266.11	Facility	26	$82.28	$126.71	$266.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.91 / $222.37 / $951.00	Professional		$183.91	$222.37	$951.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.06 / $89.34 / $368.00	Professional	26	$76.06	$89.34	$368.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.63 / $136.56 / $436.50	Professional	TC	$101.63	$136.56	$436.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $254.18 / $261.81 / $269.43	Facility	26	$254.18	$261.81	$269.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $231.21 / $449.39 / $605.24	Professional		$231.21	$449.39	$605.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.07 / $186.94 / $233.68	Professional	26	$87.07	$186.94	$233.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.99 / $248.22 / $358.81	Professional	TC	$123.99	$248.22	$358.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $165.62 / $244.34 / $1,030.66	Professional		$165.62	$244.34	$1,030.66
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.52 / $109.92 / $326.77	Professional	26	$76.52	$109.92	$326.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.10 / $135.37 / $606.52	Professional	TC	$89.10	$135.37	$606.52
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $598.00 / $770.72 / $770.72	Facility	26	$598.00	$770.72	$770.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $207.23 / $337.34 / $1,217.23	Professional		$207.23	$337.34	$1,217.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $85.12 / $110.84 / $521.24	Professional	26	$85.12	$110.84	$521.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $113.60 / $143.82 / $1,308.00	Professional	TC	$113.60	$143.82	$1,308.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $261.81 / $269.43 / $457.14	Facility	26	$261.81	$269.43	$457.14
Midlands Facility/Professional Professional Modifier Low / Median / High Price $339.46 / $408.18 / $632.87	Professional		$339.46	$408.18	$632.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $82.06 / $168.51 / $309.54	Professional		$82.06	$168.51	$309.54
United Facility/Professional Professional Modifier Low / Median / High Price $196.78 / $245.32 / $429.53	Professional		$196.78	$245.32	$429.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.12 / $106.97 / $193.29	Professional	26	$85.12	$106.97	$193.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.50 / $134.47 / $235.46	Professional	TC	$111.50	$134.47	$235.46
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $283.37 / $358.70 / $422.00	Professional		$283.37	$358.70	$422.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $124.19 / $157.19 / $185.00	Professional	26	$124.19	$157.19	$185.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $159.19 / $201.50 / $237.10	Professional	TC	$159.19	$201.50	$237.10