Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.00 / $73.47 / $155.13	Facility	26	$72.00	$73.47	$155.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.99 / $103.70 / $449.15	Professional		$47.99	$103.70	$449.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $38.67 / $153.00	Professional	26	$24.78	$38.67	$153.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.32 / $29.03 / $98.28	Professional	TC	$9.32	$29.03	$98.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.26 / $94.00 / $96.74	Facility	26	$91.26	$94.00	$96.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.53 / $136.08 / $308.98	Professional		$103.53	$136.08	$308.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.79 / $97.74 / $122.17	Professional	26	$33.79	$97.74	$122.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.92 / $31.03 / $233.51	Professional	TC	$20.92	$31.03	$233.51
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $49.03 / $75.15 / $361.84	Professional		$49.03	$75.15	$361.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.94 / $58.75 / $146.84	Professional	26	$39.94	$58.75	$146.84
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $9.09 / $14.27 / $221.80	Professional	TC	$9.09	$14.27	$221.80
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $101.38 / $193.75 / $193.75	Facility	26	$101.38	$193.75	$193.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.61 / $120.18 / $558.63	Professional		$80.61	$120.18	$558.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.25 / $40.04 / $260.82	Professional	26	$30.25	$40.04	$260.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $44.57 / $79.27 / $430.88	Professional	TC	$44.57	$79.27	$430.88
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $94.00 / $96.74 / $240.48	Facility	26	$94.00	$96.74	$240.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.52 / $150.32 / $245.25	Professional		$107.52	$150.32	$245.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.91 / $43.15 / $94.14	Professional		$10.91	$43.15	$94.14
United Facility/Professional Professional Modifier Low / Median / High Price $73.28 / $95.43 / $183.61	Professional		$73.28	$95.43	$183.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $39.40 / $82.37	Professional	26	$30.90	$39.40	$82.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.49 / $56.30 / $113.14	Professional	TC	$44.49	$56.30	$113.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $74.97 / $94.90 / $111.60	Professional		$74.97	$94.90	$111.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $59.96 / $75.90 / $89.30	Professional	26	$59.96	$75.90	$89.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $15.01 / $19.00 / $22.30	Professional	TC	$15.01	$19.00	$22.30