Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.26 / $120.00 / $221.83	Facility	26	$61.26	$120.00	$221.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.76 / $92.40 / $275.00	Professional		$73.76	$92.40	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.11 / $39.79 / $192.00	Professional	26	$36.11	$39.79	$192.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.36 / $51.12 / $213.98	Professional	TC	$36.36	$51.12	$213.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.98 / $121.52 / $125.06	Facility	26	$117.98	$121.52	$125.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.02 / $184.62 / $230.77	Professional		$97.02	$184.62	$230.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.84 / $85.33 / $118.68	Professional	26	$39.84	$85.33	$118.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.68 / $99.29 / $138.09	Professional	TC	$47.68	$99.29	$138.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $70.73 / $129.65 / $347.87	Professional		$70.73	$129.65	$347.87
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.96 / $62.83 / $124.69	Professional	26	$34.96	$62.83	$124.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.77 / $60.92 / $209.56	Professional	TC	$35.77	$60.92	$209.56
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $121.52 / $169.56 / $169.56	Facility	26	$121.52	$169.56	$169.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.86 / $133.88 / $1,002.61	Professional		$74.86	$133.88	$1,002.61
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.77 / $50.49 / $238.39	Professional	26	$38.77	$50.49	$238.39
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.21 / $53.76 / $780.59	Professional	TC	$32.21	$53.76	$780.59
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $121.52 / $125.06 / $208.62	Facility	26	$121.52	$125.06	$208.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $137.57 / $163.63 / $269.43	Professional		$137.57	$163.63	$269.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.47 / $67.78 / $135.18	Professional		$37.47	$67.78	$135.18
United Facility/Professional Professional Modifier Low / Median / High Price $73.26 / $88.61 / $164.87	Professional		$73.26	$88.61	$164.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.77 / $46.52 / $88.40	Professional	26	$38.77	$46.52	$88.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.21 / $38.97 / $96.39	Professional	TC	$32.21	$38.97	$96.39
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $107.36 / $135.90 / $159.90	Professional		$107.36	$135.90	$159.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $50.48 / $63.90 / $75.20	Professional	26	$50.48	$63.90	$75.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $56.80 / $71.90 / $84.60	Professional	TC	$56.80	$71.90	$84.60