Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.60 / $208.25 / $345.77	Facility	26	$109.60	$208.25	$345.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $348.58 / $475.00 / $2,819.77	Professional		$348.58	$475.00	$2,819.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.20 / $140.00 / $515.08	Professional	26	$98.20	$140.00	$515.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $240.85 / $335.00 / $828.53	Professional	TC	$240.85	$335.00	$828.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $333.71 / $343.72 / $353.73	Facility	26	$333.71	$343.72	$353.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $550.00 / $954.76 / $1,695.81	Professional		$550.00	$954.76	$1,695.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.81 / $236.59 / $329.05	Professional	26	$110.81	$236.59	$329.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $385.00 / $710.74 / $1,421.01	Professional	TC	$385.00	$710.74	$1,421.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $300.55 / $515.79 / $2,434.42	Professional		$300.55	$515.79	$2,434.42
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.12 / $158.85 / $347.05	Professional	26	$97.12	$158.85	$347.05
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $203.43 / $357.33 / $2,350.90	Professional	TC	$203.43	$357.33	$2,350.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $759.68 / $973.04 / $973.04	Facility	26	$759.68	$973.04	$973.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $439.03 / $778.09 / $6,025.38	Professional		$439.03	$778.09	$6,025.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $112.79 / $187.76 / $891.52	Professional	26	$112.79	$187.76	$891.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $310.27 / $517.14 / $5,457.89	Professional	TC	$310.27	$517.14	$5,457.89
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $343.72 / $353.73 / $577.50	Facility	26	$343.72	$353.73	$577.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $651.66 / $969.89 / $1,569.00	Professional		$651.66	$969.89	$1,569.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.48 / $316.50 / $562.79	Professional		$104.48	$316.50	$562.79
United Facility/Professional Professional Modifier Low / Median / High Price $397.35 / $624.94 / $1,139.82	Professional		$397.35	$624.94	$1,139.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.82 / $139.71 / $328.71	Professional	26	$110.82	$139.71	$328.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $284.43 / $452.50 / $869.86	Professional	TC	$284.43	$452.50	$869.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $604.59 / $765.30 / $900.30	Professional		$604.59	$765.30	$900.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $182.89 / $231.50 / $272.39	Professional	26	$182.89	$231.50	$272.39
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $421.70 / $533.79 / $627.90	Professional	TC	$421.70	$533.79	$627.90