Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.62 / $56.60 / $56.60	Facility	26	$30.62	$56.60	$56.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.02 / $107.06 / $400.00	Professional		$97.02	$107.06	$400.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.89 / $32.52 / $77.73	Professional	26	$28.89	$32.52	$77.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.03 / $74.16 / $104.44	Professional	TC	$66.03	$74.16	$104.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.47 / $99.36 / $102.26	Facility	26	$96.47	$99.36	$102.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.05 / $253.65 / $317.07	Professional		$99.05	$253.65	$317.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.38 / $75.23 / $94.05	Professional	26	$30.38	$75.23	$94.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.67 / $178.41 / $223.01	Professional	TC	$68.67	$178.41	$223.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $106.61 / $147.50 / $450.27	Professional		$106.61	$147.50	$450.27
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.79 / $47.70 / $123.28	Professional	26	$33.79	$47.70	$123.28
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $73.66 / $99.80 / $267.77	Professional	TC	$73.66	$99.80	$267.77
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $99.36 / $149.85 / $149.85	Facility	26	$99.36	$149.85	$149.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.91 / $152.72 / $730.62	Professional		$104.91	$152.72	$730.62
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $34.22 / $44.57 / $210.44	Professional	26	$34.22	$44.57	$210.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $67.98 / $88.02 / $520.19	Professional	TC	$67.98	$88.02	$520.19
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $99.36 / $102.26 / $183.18	Facility	26	$99.36	$102.26	$183.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $205.36 / $230.56 / $366.80	Professional		$205.36	$230.56	$366.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.29 / $96.92 / $177.48	Professional		$33.29	$96.92	$177.48
United Facility/Professional Professional Modifier Low / Median / High Price $101.82 / $130.28 / $213.51	Professional		$101.82	$130.28	$213.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.22 / $42.88 / $72.48	Professional	26	$34.22	$42.88	$72.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.98 / $85.48 / $144.97	Professional	TC	$67.98	$85.48	$144.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $146.15 / $185.00 / $217.60	Professional		$146.15	$185.00	$217.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $44.64 / $56.50 / $66.50	Professional	26	$44.64	$56.50	$66.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $101.52 / $128.50 / $151.10	Professional	TC	$101.52	$128.50	$151.10