Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.44 / $263.99 / $487.66	Facility	26	$131.44	$263.99	$487.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $311.25 / $425.00 / $700.00	Professional		$311.25	$425.00	$700.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.33 / $124.32 / $154.00	Professional	26	$82.33	$124.32	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $226.44 / $318.39 / $424.84	Professional	TC	$226.44	$318.39	$424.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $256.62 / $264.32 / $272.02	Facility	26	$256.62	$264.32	$272.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $450.92 / $740.76 / $1,466.57	Professional		$450.92	$740.76	$1,466.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.38 / $185.39 / $254.94	Professional	26	$86.38	$185.39	$254.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $341.24 / $553.12 / $1,254.42	Professional	TC	$341.24	$553.12	$1,254.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $267.70 / $460.13 / $1,607.67	Professional		$267.70	$460.13	$1,607.67
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.91 / $124.49 / $370.97	Professional	26	$75.91	$124.49	$370.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $191.80 / $336.99 / $1,374.08	Professional	TC	$191.80	$336.99	$1,374.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $593.12 / $764.32 / $764.32	Facility	26	$593.12	$764.32	$764.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $393.54 / $655.90 / $3,392.38	Professional		$393.54	$655.90	$3,392.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.92 / $142.05 / $667.05	Professional	26	$87.92	$142.05	$667.05
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $291.83 / $469.36 / $2,981.99	Professional	TC	$291.83	$469.36	$2,981.99
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $264.32 / $272.02 / $453.36	Facility	26	$264.32	$272.02	$453.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $581.83 / $797.35 / $1,082.00	Professional		$581.83	$797.35	$1,082.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $81.40 / $281.67 / $500.80	Professional		$81.40	$281.67	$500.80
United Facility/Professional Professional Modifier Low / Median / High Price $360.75 / $537.84 / $1,022.59	Professional		$360.75	$537.84	$1,022.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $86.46 / $127.14 / $252.43	Professional	26	$86.46	$127.14	$252.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $269.16 / $425.58 / $1,580.38	Professional	TC	$269.16	$425.58	$1,580.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $540.44 / $684.10 / $804.90	Professional		$540.44	$684.10	$804.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $142.91 / $180.90 / $212.80	Professional	26	$142.91	$180.90	$212.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $397.53 / $503.20 / $592.00	Professional	TC	$397.53	$503.20	$592.00