Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.81 / $298.68 / $984.55	Facility		$97.81	$298.68	$984.55
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.39 / $65.34 / $123.25	Facility	26	$34.39	$65.34	$123.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.22 / $136.33 / $661.00	Professional		$102.22	$136.33	$661.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.40 / $43.72 / $190.00	Professional	26	$34.40	$43.72	$190.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.81 / $87.95 / $437.00	Professional	TC	$67.81	$87.95	$437.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $436.25 / $449.34 / $462.43	Facility		$436.25	$449.34	$462.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.59 / $124.21 / $127.83	Facility	26	$120.59	$124.21	$127.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.65 / $269.94 / $360.24	Professional		$129.65	$269.94	$360.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.52 / $86.88 / $118.33	Professional	26	$44.52	$86.88	$118.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.20 / $183.07 / $260.57	Professional	TC	$88.20	$183.07	$260.57
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $103.58 / $170.91 / $411.62	Professional		$103.58	$170.91	$411.62
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.61 / $57.89 / $146.56	Professional	26	$35.61	$57.89	$146.56
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $65.84 / $112.24 / $234.23	Professional	TC	$65.84	$112.24	$234.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.22 / $227.63 / $485.26	Facility		$102.22	$227.63	$485.26
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $124.21 / $172.60 / $172.60	Facility	26	$124.21	$172.60	$172.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $121.02 / $189.03 / $760.68	Professional		$121.02	$189.03	$760.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $39.82 / $51.85 / $303.79	Professional	26	$39.82	$51.85	$303.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $79.20 / $100.29 / $518.02	Professional	TC	$79.20	$100.29	$518.02
Midlands Facility/Professional Facility Modifier Low / Median / High Price $93.57 / $231.00 / $391.72	Facility		$93.57	$231.00	$391.72
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $124.21 / $127.83 / $211.98	Facility	26	$124.21	$127.83	$211.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $196.12 / $246.22 / $387.95	Professional		$196.12	$246.22	$387.95
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $100.98 / $1,220.18 / $2,107.58	Facility		$100.98	$1,220.18	$2,107.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.22 / $106.57 / $190.23	Professional		$38.22	$106.57	$190.23
United Facility/Professional Professional Modifier Low / Median / High Price $118.97 / $142.77 / $264.87	Professional		$118.97	$142.77	$264.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.49 / $47.78 / $88.71	Professional	26	$39.49	$47.78	$88.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.20 / $94.85 / $173.36	Professional	TC	$73.20	$94.85	$173.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $162.03 / $205.10 / $241.30	Professional		$162.03	$205.10	$241.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $53.40 / $67.59 / $79.50	Professional	26	$53.40	$67.59	$79.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $108.63 / $137.50 / $161.80	Professional	TC	$108.63	$137.50	$161.80