Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.55 / $53.04 / $100.83	Facility	26	$28.55	$53.04	$100.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.37 / $114.80 / $465.00	Professional		$71.37	$114.80	$465.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.64 / $46.37 / $171.20	Professional	26	$27.64	$46.37	$171.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.44 / $62.21 / $139.72	Professional	TC	$43.44	$62.21	$139.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.89 / $97.74 / $100.58	Facility	26	$94.89	$97.74	$100.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.81 / $188.50 / $235.62	Professional		$96.81	$188.50	$235.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.54 / $70.59 / $90.56	Professional	26	$35.54	$70.59	$90.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.95 / $117.91 / $155.19	Professional	TC	$59.95	$117.91	$155.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $71.28 / $121.04 / $249.65	Professional		$71.28	$121.04	$249.65
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.72 / $46.61 / $118.52	Professional	26	$28.72	$46.61	$118.52
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.56 / $72.44 / $182.91	Professional	TC	$42.56	$72.44	$182.91
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $97.74 / $139.28 / $139.28	Facility	26	$97.74	$139.28	$139.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.01 / $133.00 / $524.64	Professional		$83.01	$133.00	$524.64
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $31.77 / $41.37 / $195.35	Professional	26	$31.77	$41.37	$195.35
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $49.65 / $62.80 / $329.23	Professional	TC	$49.65	$62.80	$329.23
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $97.74 / $100.58 / $170.94	Facility	26	$97.74	$100.58	$170.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $142.38 / $172.22 / $225.86	Professional		$142.38	$172.22	$225.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.82 / $58.28 / $134.75	Professional		$30.82	$58.28	$134.75
United Facility/Professional Professional Modifier Low / Median / High Price $77.30 / $94.87 / $181.68	Professional		$77.30	$94.87	$181.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.77 / $39.84 / $71.45	Professional	26	$31.77	$39.84	$71.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.65 / $61.58 / $109.33	Professional	TC	$49.65	$61.58	$109.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $113.37 / $143.50 / $168.80	Professional		$113.37	$143.50	$168.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $43.06 / $54.50 / $64.20	Professional	26	$43.06	$54.50	$64.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $70.23 / $88.90 / $104.60	Professional	TC	$70.23	$88.90	$104.60