Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.68 / $46.68 / $87.31	Facility	26	$46.68	$46.68	$87.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.67 / $101.07 / $246.51	Professional		$51.67	$101.07	$246.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.57 / $26.93 / $144.35	Professional	26	$24.57	$26.93	$144.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.01 / $37.77 / $93.00	Professional	TC	$26.01	$37.77	$93.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.33 / $89.95 / $92.57	Facility	26	$87.33	$89.95	$92.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.32 / $141.18 / $281.92	Professional		$87.32	$141.18	$281.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.95 / $62.83 / $86.15	Professional	26	$31.95	$62.83	$86.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.67 / $78.34 / $192.43	Professional	TC	$47.67	$78.34	$192.43
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $54.79 / $102.53 / $257.12	Professional		$54.79	$102.53	$257.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.60 / $41.70 / $120.66	Professional	26	$25.60	$41.70	$120.66
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.38 / $53.67 / $159.97	Professional	TC	$28.38	$53.67	$159.97
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $89.95 / $124.11 / $124.11	Facility	26	$89.95	$124.11	$124.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.70 / $109.15 / $562.97	Professional		$60.70	$109.15	$562.97
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.27 / $36.81 / $186.58	Professional	26	$28.27	$36.81	$186.58
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.66 / $52.73 / $399.92	Professional	TC	$29.66	$52.73	$399.92
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $89.95 / $92.57 / $151.80	Facility	26	$89.95	$92.57	$151.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.31 / $130.04 / $206.05	Professional		$112.31	$130.04	$206.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.51 / $50.91 / $103.58	Professional		$27.51	$50.91	$103.58
United Facility/Professional Professional Modifier Low / Median / High Price $58.99 / $72.39 / $132.79	Professional		$58.99	$72.39	$132.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.11 / $33.93 / $63.69	Professional	26	$28.11	$33.93	$63.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.80 / $40.98 / $81.56	Professional	TC	$28.80	$40.98	$81.56
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $85.24 / $107.90 / $126.90	Professional		$85.24	$107.90	$126.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $38.39 / $48.60 / $57.20	Professional	26	$38.39	$48.60	$57.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $46.85 / $59.30 / $69.80	Professional	TC	$46.85	$59.30	$69.80