Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.03 / $117.55 / $278.66	Facility	26	$86.03	$117.55	$278.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.32 / $354.51 / $1,724.00	Professional		$281.32	$354.51	$1,724.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.92 / $99.11 / $417.60	Professional	26	$79.92	$99.11	$417.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.00 / $260.58 / $749.00	Professional	TC	$220.00	$260.58	$749.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $267.02 / $275.04 / $283.05	Facility	26	$267.02	$275.04	$283.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $367.43 / $720.63 / $900.78	Professional		$367.43	$720.63	$900.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.92 / $196.25 / $245.32	Professional	26	$91.92	$196.25	$245.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.45 / $524.37 / $679.18	Professional	TC	$263.45	$524.37	$679.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $268.08 / $399.13 / $1,459.84	Professional		$268.08	$399.13	$1,459.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $80.55 / $115.37 / $358.96	Professional	26	$80.55	$115.37	$358.96
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $187.53 / $283.45 / $1,030.60	Professional	TC	$187.53	$283.45	$1,030.60
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $630.16 / $805.76 / $805.76	Facility	26	$630.16	$805.76	$805.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $336.23 / $535.09 / $2,077.84	Professional		$336.23	$535.09	$2,077.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $93.31 / $133.97 / $547.02	Professional	26	$93.31	$133.97	$547.02
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $231.15 / $288.31 / $2,614.00	Professional	TC	$231.15	$288.31	$2,614.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $275.04 / $283.05 / $478.26	Facility	26	$275.04	$283.05	$478.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $535.09 / $653.97 / $1,040.41	Professional		$535.09	$653.97	$1,040.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $86.69 / $285.73 / $501.73	Professional		$86.69	$285.73	$501.73
United Facility/Professional Professional Modifier Low / Median / High Price $320.36 / $398.03 / $696.90	Professional		$320.36	$398.03	$696.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.32 / $111.97 / $203.65	Professional	26	$89.32	$111.97	$203.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $231.15 / $281.72 / $756.37	Professional	TC	$231.15	$281.72	$756.37
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $465.94 / $589.79 / $693.80	Professional		$465.94	$589.79	$693.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $130.82 / $165.60 / $194.80	Professional	26	$130.82	$165.60	$194.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $335.12 / $424.20 / $499.10	Professional	TC	$335.12	$424.20	$499.10