Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $101.29 / $146.44	Professional		$77.42	$101.29	$146.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.19 / $17.30 / $25.70	Professional	26	$16.19	$17.30	$25.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.11 / $84.45 / $120.74	Professional	TC	$60.11	$84.45	$120.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $234.12 / $323.85	Professional		$83.18	$234.12	$323.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.87 / $42.66 / $53.33	Professional	26	$19.87	$42.66	$53.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.68 / $194.28 / $270.52	Professional	TC	$65.68	$194.28	$270.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $94.88 / $129.72 / $189.71	Professional		$94.88	$129.72	$189.71
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.42 / $28.44 / $42.00	Professional	26	$17.42	$28.44	$42.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $62.79 / $95.15 / $151.59	Professional	TC	$62.79	$95.15	$151.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.00 / $151.11 / $751.09	Professional		$91.00	$151.11	$751.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.12 / $24.00 / $205.00	Professional	26	$19.12	$24.00	$205.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $59.36 / $107.83 / $630.88	Professional	TC	$59.36	$107.83	$630.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $111.81 / $222.08 / $293.05	Professional		$111.81	$222.08	$293.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.80 / $97.79 / $187.76	Professional		$18.80	$97.79	$187.76
United Facility/Professional Professional Modifier Low / Median / High Price $93.82 / $125.93 / $202.69	Professional		$93.82	$125.93	$202.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.52 / $24.00 / $44.57	Professional	26	$18.52	$24.00	$44.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.19 / $107.18 / $167.83	Professional	TC	$78.19	$107.18	$167.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $148.36 / $187.80 / $221.00	Professional		$148.36	$187.80	$221.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $25.28 / $32.00 / $37.60	Professional	26	$25.28	$32.00	$37.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $123.16 / $155.90 / $183.40	Professional	TC	$123.16	$155.90	$183.40