Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.61 / $138.79 / $356.89	Facility	26	$63.61	$138.79	$356.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.93 / $425.00 / $1,269.16	Professional		$202.93	$425.00	$1,269.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.41 / $126.00 / $331.20	Professional	26	$70.41	$126.00	$331.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.31 / $258.62 / $422.10	Professional	TC	$131.31	$258.62	$422.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $217.79 / $224.32 / $230.86	Facility	26	$217.79	$224.32	$230.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $322.77 / $540.28 / $1,076.43	Professional		$322.77	$540.28	$1,076.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.92 / $155.91 / $214.09	Professional	26	$72.92	$155.91	$214.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $233.59 / $359.29 / $898.45	Professional	TC	$233.59	$359.29	$898.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $174.70 / $323.08 / $1,338.43	Professional		$174.70	$323.08	$1,338.43
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.04 / $107.36 / $221.41	Professional	26	$64.04	$107.36	$221.41
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $110.66 / $207.93 / $1,143.31	Professional	TC	$110.66	$207.93	$1,143.31
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $500.48 / $647.12 / $647.12	Facility	26	$500.48	$647.12	$647.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $253.03 / $441.41 / $2,831.41	Professional		$253.03	$441.41	$2,831.41
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $74.06 / $120.12 / $579.54	Professional	26	$74.06	$120.12	$579.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $167.12 / $278.54 / $2,465.48	Professional	TC	$167.12	$278.54	$2,465.48
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $224.32 / $230.86 / $383.52	Facility	26	$224.32	$230.86	$383.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $382.20 / $560.69 / $872.00	Professional		$382.20	$560.69	$872.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.70 / $183.07 / $326.57	Professional		$68.70	$183.07	$326.57
United Facility/Professional Professional Modifier Low / Median / High Price $231.95 / $369.01 / $698.32	Professional		$231.95	$369.01	$698.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.61 / $105.10 / $212.67	Professional	26	$73.61	$105.10	$212.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $153.19 / $239.08 / $479.56	Professional	TC	$153.19	$239.08	$479.56
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $349.89 / $442.90 / $521.10	Professional		$349.89	$442.90	$521.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $120.55 / $152.60 / $179.50	Professional	26	$120.55	$152.60	$179.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $229.34 / $290.30 / $341.60	Professional	TC	$229.34	$290.30	$341.60