Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.76 / $179.66 / $493.33	Facility	26	$87.76	$179.66	$493.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $332.95 / $434.02 / $1,957.00	Professional		$332.95	$434.02	$1,957.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.53 / $99.40 / $351.13	Professional	26	$84.53	$99.40	$351.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $232.65 / $315.29 / $821.47	Professional	TC	$232.65	$315.29	$821.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $293.36 / $302.16 / $310.95	Facility	26	$293.36	$302.16	$310.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $421.18 / $806.73 / $1,139.08	Professional		$421.18	$806.73	$1,139.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.70 / $215.64 / $269.56	Professional	26	$100.70	$215.64	$269.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $302.83 / $591.08 / $897.03	Professional	TC	$302.83	$591.08	$897.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $300.05 / $446.73 / $1,296.83	Professional		$300.05	$446.73	$1,296.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $88.39 / $126.81 / $288.99	Professional	26	$88.39	$126.81	$288.99
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $211.66 / $321.99 / $962.15	Professional	TC	$211.66	$321.99	$962.15
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $690.96 / $887.84 / $887.84	Facility	26	$690.96	$887.84	$887.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $377.98 / $622.89 / $2,235.14	Professional		$377.98	$622.89	$2,235.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $98.66 / $127.80 / $600.70	Professional	26	$98.66	$127.80	$600.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $270.02 / $343.67 / $2,909.00	Professional	TC	$270.02	$343.67	$2,909.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $302.16 / $310.95 / $526.98	Facility	26	$302.16	$310.95	$526.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $610.37 / $732.27 / $1,164.98	Professional		$610.37	$732.27	$1,164.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $95.05 / $317.56 / $561.44	Professional		$95.05	$317.56	$561.44
United Facility/Professional Professional Modifier Low / Median / High Price $360.80 / $447.46 / $783.45	Professional		$360.80	$447.46	$783.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.66 / $127.59 / $296.12	Professional	26	$98.66	$127.59	$296.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $268.07 / $319.66 / $556.15	Professional	TC	$268.07	$319.66	$556.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $521.72 / $660.40 / $776.90	Professional		$521.72	$660.40	$776.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $143.46 / $181.60 / $213.70	Professional	26	$143.46	$181.60	$213.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $378.17 / $478.70 / $563.20	Professional	TC	$378.17	$478.70	$563.20