Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.96 / $61.21 / $116.63	Facility	26	$32.96	$61.21	$116.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.80 / $154.65 / $485.00	Professional		$81.80	$154.65	$485.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.13 / $49.61 / $191.54	Professional	26	$32.13	$49.61	$191.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.18 / $59.57 / $146.50	Professional	TC	$49.18	$59.57	$146.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.23 / $115.60 / $118.96	Facility	26	$112.23	$115.60	$118.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.89 / $214.87 / $268.58	Professional		$104.89	$214.87	$268.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.93 / $81.45 / $103.53	Professional	26	$40.93	$81.45	$103.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.96 / $133.41 / $170.86	Professional	TC	$63.96	$133.41	$170.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $81.04 / $137.85 / $338.34	Professional		$81.04	$137.85	$338.34
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.09 / $56.00 / $147.63	Professional	26	$33.09	$56.00	$147.63
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.95 / $83.66 / $188.37	Professional	TC	$47.95	$83.66	$188.37
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $115.60 / $163.00 / $163.00	Facility	26	$115.60	$163.00	$163.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $94.13 / $153.34 / $600.27	Professional		$94.13	$153.34	$600.27
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $36.69 / $47.78 / $233.19	Professional	26	$36.69	$47.78	$233.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $56.19 / $69.70 / $372.64	Professional	TC	$56.19	$69.70	$372.64
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $115.60 / $118.96 / $199.56	Facility	26	$115.60	$118.96	$199.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $163.22 / $195.69 / $256.82	Professional		$163.22	$195.69	$256.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.43 / $66.67 / $153.81	Professional		$35.43	$66.67	$153.81
United Facility/Professional Professional Modifier Low / Median / High Price $90.20 / $116.93 / $208.16	Professional		$90.20	$116.93	$208.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.69 / $47.78 / $92.40	Professional	26	$36.69	$47.78	$92.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.91 / $65.11 / $125.38	Professional	TC	$53.91	$65.11	$125.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $128.77 / $163.00 / $191.80	Professional		$128.77	$163.00	$191.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $49.61 / $62.80 / $73.90	Professional	26	$49.61	$62.80	$73.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $79.16 / $100.20 / $117.90	Professional	TC	$79.16	$100.20	$117.90