Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.79 / $315.86 / $834.50	Facility		$64.79	$315.86	$834.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.37 / $23.37 / $44.37	Facility	26	$23.37	$23.37	$44.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.91 / $36.29 / $66.81	Professional		$30.91	$36.29	$66.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $14.52 / $77.00	Professional	26	$12.30	$14.52	$77.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $21.80 / $41.42	Professional	TC	$17.89	$21.80	$41.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.03 / $110.24 / $113.45	Facility		$107.03	$110.24	$113.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.97 / $46.32 / $47.67	Facility	26	$44.97	$46.32	$47.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.14 / $89.21 / $111.51	Professional		$40.14	$89.21	$111.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.73 / $30.25 / $45.89	Professional	26	$16.73	$30.25	$45.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.47 / $58.95 / $73.69	Professional	TC	$21.47	$58.95	$73.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $33.85 / $54.20 / $129.22	Professional		$33.85	$54.20	$129.22
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.56 / $20.58 / $65.34	Professional	26	$12.56	$20.58	$65.34
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.29 / $32.92 / $47.11	Professional	TC	$21.29	$32.92	$47.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.78 / $69.63 / $110.24	Facility		$34.78	$69.63	$110.24
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $46.32 / $100.00 / $100.00	Facility	26	$46.32	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.36 / $64.00 / $287.00	Professional		$34.36	$64.00	$287.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.66 / $18.85 / $204.67	Professional	26	$14.66	$18.85	$204.67
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.29 / $26.44 / $230.00	Professional	TC	$18.29	$26.44	$230.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $64.00 / $81.84 / $130.19	Facility		$64.00	$81.84	$130.19
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $46.32 / $47.67 / $75.12	Facility	26	$46.32	$47.67	$75.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $57.65 / $74.56 / $116.74	Professional		$57.65	$74.56	$116.74
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,049.74 / $16,996.34 / $34,599.74	Facility		$3,049.74	$16,996.34	$34,599.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $34.36 / $68.92	Professional		$14.00	$34.36	$68.92
United Facility/Professional Professional Modifier Low / Median / High Price $32.65 / $44.60 / $79.26	Professional		$32.65	$44.60	$79.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.33 / $18.34 / $42.03	Professional	26	$14.33	$18.34	$42.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.27 / $26.42 / $49.44	Professional	TC	$19.27	$26.42	$49.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $53.88 / $68.20 / $80.20	Professional		$53.88	$68.20	$80.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $18.72 / $23.70 / $27.90	Professional	26	$18.72	$23.70	$27.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $35.15 / $44.50 / $52.30	Professional	TC	$35.15	$44.50	$52.30