Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $131.36 / $280.72	Facility	26	$63.88	$131.36	$280.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.58 / $163.03 / $285.24	Professional		$137.58	$163.03	$285.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.55 / $70.01 / $284.16	Professional	26	$52.55	$70.01	$284.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.44 / $97.59 / $220.00	Professional	TC	$68.44	$97.59	$220.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $168.86 / $173.93 / $178.99	Facility	26	$168.86	$173.93	$178.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.95 / $328.99 / $405.65	Professional		$172.95	$328.99	$405.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.56 / $155.91 / $202.69	Professional	26	$69.56	$155.91	$202.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.33 / $168.75 / $309.64	Professional	TC	$82.33	$168.75	$309.64
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $113.30 / $167.11 / $661.83	Professional		$113.30	$167.11	$661.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.50 / $99.38 / $321.57	Professional	26	$64.50	$99.38	$321.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.80 / $76.34 / $394.99	Professional	TC	$48.80	$76.34	$394.99
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $503.20 / $646.64 / $646.64	Facility	26	$503.20	$646.64	$646.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $157.01 / $268.99 / $1,406.40	Professional		$157.01	$268.99	$1,406.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.13 / $105.15 / $439.49	Professional	26	$63.13	$105.15	$439.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $77.58 / $121.88 / $1,140.03	Professional	TC	$77.58	$121.88	$1,140.03
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $173.93 / $178.99 / $382.92	Facility	26	$173.93	$178.99	$382.92
Midlands Facility/Professional Professional Modifier Low / Median / High Price $240.32 / $274.31 / $427.95	Professional		$240.32	$274.31	$427.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.49 / $114.28 / $215.34	Professional		$56.49	$114.28	$215.34
United Facility/Professional Professional Modifier Low / Median / High Price $151.47 / $185.88 / $328.87	Professional		$151.47	$185.88	$328.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.15 / $94.04 / $165.73	Professional	26	$71.15	$94.04	$165.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.58 / $108.63 / $231.04	Professional	TC	$77.58	$108.63	$231.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $169.46 / $214.50 / $252.30	Professional		$169.46	$214.50	$252.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $92.35 / $116.90 / $137.50	Professional	26	$92.35	$116.90	$137.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $77.09 / $97.60 / $114.80	Professional	TC	$77.09	$97.60	$114.80