Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.60 / $62.43 / $119.88	Facility	26	$50.60	$62.43	$119.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.01 / $91.23 / $433.46	Professional		$74.01	$91.23	$433.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.86 / $42.48 / $183.95	Professional	26	$32.86	$42.48	$183.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.15 / $50.36 / $112.58	Professional	TC	$41.15	$50.36	$112.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $115.85 / $119.33 / $122.80	Facility	26	$115.85	$119.33	$122.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.17 / $200.13 / $256.22	Professional		$105.17	$200.13	$256.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.09 / $83.78 / $114.87	Professional	26	$42.09	$83.78	$114.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.37 / $116.36 / $145.44	Professional	TC	$59.37	$116.36	$145.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $76.02 / $140.19 / $341.09	Professional		$76.02	$140.19	$341.09
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.72 / $58.10 / $123.67	Professional	26	$33.72	$58.10	$123.67
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.29 / $74.93 / $325.31	Professional	TC	$42.29	$74.93	$325.31
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $119.33 / $163.47 / $163.47	Facility	26	$119.33	$163.47	$163.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $88.42 / $154.00 / $555.44	Professional		$88.42	$154.00	$555.44
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $37.60 / $49.15 / $269.13	Professional	26	$37.60	$49.15	$269.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $48.75 / $60.72 / $351.46	Professional	TC	$48.75	$60.72	$351.46
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $119.33 / $122.80 / $204.72	Facility	26	$119.33	$122.80	$204.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $154.00 / $182.89 / $256.22	Professional		$154.00	$182.89	$256.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.59 / $79.00 / $145.41	Professional		$36.59	$79.00	$145.41
United Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $106.10 / $188.62	Professional		$84.00	$106.10	$188.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.74 / $45.29 / $86.84	Professional	26	$37.74	$45.29	$86.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.63 / $57.73 / $107.91	Professional	TC	$46.63	$57.73	$107.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $120.40 / $152.40 / $179.30	Professional		$120.40	$152.40	$179.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $50.56 / $64.00 / $75.30	Professional	26	$50.56	$64.00	$75.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $69.76 / $88.30 / $103.90	Professional	TC	$69.76	$88.30	$103.90