Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.82 / $186.12 / $186.12	Facility	26	$100.82	$186.12	$186.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.74 / $475.00 / $1,659.20	Professional		$312.74	$475.00	$1,659.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.96 / $140.00 / $400.40	Professional	26	$97.96	$140.00	$400.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $214.79 / $266.14 / $422.10	Professional	TC	$214.79	$266.14	$422.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $321.98 / $331.64 / $341.30	Facility	26	$321.98	$331.64	$341.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $369.66 / $814.49 / $1,254.71	Professional		$369.66	$814.49	$1,254.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.92 / $247.45 / $373.87	Professional	26	$109.92	$247.45	$373.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $269.83 / $567.04 / $880.83	Professional	TC	$269.83	$567.04	$880.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $342.69 / $474.11 / $1,579.14	Professional		$342.69	$474.11	$1,579.14
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $110.91 / $157.04 / $445.90	Professional	26	$110.91	$157.04	$445.90
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $234.09 / $317.07 / $1,112.59	Professional	TC	$234.09	$317.07	$1,112.59
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $796.48 / $1,020.08 / $1,020.08	Facility	26	$796.48	$1,020.08	$1,020.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $446.09 / $740.81 / $2,337.81	Professional		$446.09	$740.81	$2,337.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $92.63 / $168.77 / $687.65	Professional	26	$92.63	$168.77	$687.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $311.08 / $500.31 / $1,650.16	Professional	TC	$311.08	$500.31	$1,650.16
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $331.64 / $341.30 / $604.98	Facility	26	$331.64	$341.30	$604.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $668.44 / $740.81 / $1,254.71	Professional		$668.44	$740.81	$1,254.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $108.15 / $242.87 / $570.66	Professional		$108.15	$242.87	$570.66
United Facility/Professional Professional Modifier Low / Median / High Price $408.91 / $650.54 / $1,249.76	Professional		$408.91	$650.54	$1,249.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.95 / $167.99 / $287.95	Professional	26	$95.95	$167.99	$287.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $285.14 / $453.65 / $874.20	Professional	TC	$285.14	$453.65	$874.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $612.25 / $775.00 / $911.70	Professional		$612.25	$775.00	$911.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $191.73 / $242.70 / $285.50	Professional	26	$191.73	$242.70	$285.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $420.52 / $532.29 / $626.20	Professional	TC	$420.52	$532.29	$626.20