Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.14 / $55.99 / $104.20	Facility	26	$30.14	$55.99	$104.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.42 / $125.83 / $574.00	Professional		$92.42	$125.83	$574.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.47 / $37.54 / $138.00	Professional	26	$29.47	$37.54	$138.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.95 / $83.28 / $430.43	Professional	TC	$62.95	$83.28	$430.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.95 / $106.04 / $109.13	Facility	26	$102.95	$106.04	$109.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.84 / $245.90 / $320.37	Professional		$108.84	$245.90	$320.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.72 / $74.47 / $100.85	Professional	26	$37.72	$74.47	$100.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.39 / $171.43 / $214.29	Professional	TC	$71.39	$171.43	$214.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $91.88 / $151.59 / $365.36	Professional		$91.88	$151.59	$365.36
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.30 / $49.07 / $126.40	Professional	26	$30.30	$49.07	$126.40
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $61.58 / $96.48 / $206.44	Professional	TC	$61.58	$96.48	$206.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $106.04 / $171.00 / $171.00	Facility	26	$106.04	$171.00	$171.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $107.90 / $167.89 / $687.27	Professional		$107.90	$167.89	$687.27
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.54 / $43.68 / $254.27	Professional	26	$33.54	$43.68	$254.27
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $69.22 / $91.81 / $479.00	Professional	TC	$69.22	$91.81	$479.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $106.04 / $109.13 / $180.60	Facility	26	$106.04	$109.13	$180.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $157.11 / $223.45 / $293.26	Professional		$157.11	$223.45	$293.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.71 / $97.31 / $173.70	Professional		$32.71	$97.31	$173.70
United Facility/Professional Professional Modifier Low / Median / High Price $103.10 / $126.09 / $226.30	Professional		$103.10	$126.09	$226.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.54 / $40.25 / $77.14	Professional	26	$33.54	$40.25	$77.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.68 / $90.13 / $151.34	Professional	TC	$72.68	$90.13	$151.34
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $147.10 / $186.20 / $219.00	Professional		$147.10	$186.20	$219.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $45.43 / $57.50 / $67.70	Professional	26	$45.43	$57.50	$67.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $101.67 / $128.69 / $151.40	Professional	TC	$101.67	$128.69	$151.40