Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $309.03 / $724.44	Facility		$37.15	$309.03	$724.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $23.44 / $28.84	Facility	26	$12.02	$23.44	$28.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $38.90 / $95.50	Professional		$29.51	$38.90	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $20.89 / $77.62	Professional	26	$10.96	$20.89	$77.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $22.91 / $48.98	Professional	TC	$17.78	$22.91	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $109.65 / $112.20	Facility		$107.15	$109.65	$112.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $46.77 / $47.86	Facility	26	$44.67	$46.77	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $91.20 / $114.82	Professional		$33.88	$91.20	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $30.90 / $38.90	Professional	26	$16.22	$30.90	$38.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $60.26 / $75.86	Professional	TC	$19.95	$60.26	$75.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $64.57 / $144.54	Professional		$35.48	$64.57	$144.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $26.92 / $104.71	Professional	26	$12.59	$26.92	$104.71
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $36.31 / $64.57	Professional	TC	$22.39	$36.31	$64.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $67.61 / $512.86	Facility		$34.67	$67.61	$512.86
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $100.00 / $100.00	Facility	26	$46.77	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $58.88 / $288.40	Professional		$32.36	$58.88	$288.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $18.62 / $204.17	Professional	26	$14.13	$18.62	$204.17
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $26.30 / $229.09	Professional	TC	$16.98	$26.30	$229.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $81.28 / $102.33	Professional		$69.18	$81.28	$102.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $30.90 / $45.71	Professional	26	$27.54	$30.90	$45.71
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $53.70 / $63.10	Professional	TC	$38.90	$53.70	$63.10
Midlands Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $47.86 / $47.86	Facility	26	$47.86	$47.86	$47.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $89.13 / $102.33	Professional		$72.44	$89.13	$102.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $31.62 / $36.31	Professional	26	$28.84	$31.62	$36.31
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $58.88 / $66.07	Professional	TC	$42.66	$58.88	$66.07
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $12,022.64 / $33,884.42	Facility		$3,311.31	$12,022.64	$33,884.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $30.90 / $70.79	Professional		$14.45	$30.90	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $41.69 / $77.62	Professional		$32.36	$41.69	$77.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $16.98 / $32.36	Professional	26	$14.13	$16.98	$32.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $23.99 / $50.12	Professional	TC	$17.38	$23.99	$50.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $67.61 / $79.43	Professional		$64.57	$67.61	$79.43
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $25.70 / $64.57	Professional	26	$23.44	$25.70	$64.57
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $48.98 / $64.57	Professional	TC	$44.67	$48.98	$64.57