Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.51 / $213.67 / $580.15	Facility	26	$104.51	$213.67	$580.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $335.52 / $702.26	Professional		$275.00	$335.52	$702.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.31 / $119.07 / $563.00	Professional	26	$100.31	$119.07	$563.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.49 / $220.00 / $320.13	Professional	TC	$168.49	$220.00	$320.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $345.39 / $355.75 / $366.11	Facility	26	$345.39	$355.75	$366.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $401.55 / $768.72 / $1,164.71	Professional		$401.55	$768.72	$1,164.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $119.95 / $256.76 / $320.95	Professional	26	$119.95	$256.76	$320.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $296.77 / $511.96 / $877.38	Professional	TC	$296.77	$511.96	$877.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $288.87 / $428.38 / $1,337.48	Professional		$288.87	$428.38	$1,337.48
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $105.29 / $152.05 / $346.82	Professional	26	$105.29	$152.05	$346.82
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $183.59 / $279.99 / $839.39	Professional	TC	$183.59	$279.99	$839.39
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $822.80 / $1,056.00 / $1,056.00	Facility	26	$822.80	$1,056.00	$1,056.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $371.31 / $631.04 / $2,091.94	Professional		$371.31	$631.04	$2,091.94
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $116.14 / $151.24 / $711.82	Professional	26	$116.14	$151.24	$711.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $243.55 / $403.94 / $1,773.11	Professional	TC	$243.55	$403.94	$1,773.11
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $355.75 / $366.11 / $627.60	Facility	26	$355.75	$366.11	$627.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $530.66 / $700.24 / $1,114.02	Professional		$530.66	$700.24	$1,114.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $113.03 / $307.60 / $540.92	Professional		$113.03	$307.60	$540.92
United Facility/Professional Professional Modifier Low / Median / High Price $362.71 / $439.56 / $820.37	Professional		$362.71	$439.56	$820.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $116.14 / $142.62 / $264.80	Professional	26	$116.14	$142.62	$264.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $243.55 / $293.63 / $614.64	Professional	TC	$243.55	$293.63	$614.64
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $498.89 / $631.50 / $742.90	Professional		$498.89	$631.50	$742.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $170.88 / $216.30 / $254.40	Professional	26	$170.88	$216.30	$254.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $328.01 / $415.20 / $488.50	Professional	TC	$328.01	$415.20	$488.50