Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.53 / $46.84 / $61.82	Facility	26	$32.53	$46.84	$61.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.83 / $162.94 / $580.79	Professional		$111.83	$162.94	$580.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.71 / $40.86 / $110.00	Professional	26	$32.71	$40.86	$110.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $31.90 / $96.92 / $726.00	Professional	52	$31.90	$96.92	$726.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.00 / $95.82 / $211.63	Professional	TC	$81.00	$95.82	$211.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.53 / $121.06 / $124.58	Facility	26	$117.53	$121.06	$124.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.58 / $301.75 / $377.18	Professional		$141.58	$301.75	$377.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.36 / $82.22 / $102.78	Professional	26	$36.36	$82.22	$102.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.80 / $219.52 / $274.39	Professional	TC	$100.80	$219.52	$274.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $126.61 / $168.24 / $510.61	Professional		$126.61	$168.24	$510.61
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.78 / $48.66 / $110.73	Professional	26	$36.78	$48.66	$110.73
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.83 / $119.58 / $359.70	Professional	TC	$89.83	$119.58	$359.70
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $121.06 / $163.47 / $163.47	Facility	26	$121.06	$163.47	$163.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $140.65 / $234.04 / $585.71	Professional		$140.65	$234.04	$585.71
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $39.34 / $53.57 / $227.63	Professional	26	$39.34	$53.57	$227.63
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $94.97 / $119.69 / $598.35	Professional	TC	$94.97	$119.69	$598.35
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $121.06 / $124.58 / $200.34	Facility	26	$121.06	$124.58	$200.34
Midlands Facility/Professional Professional Modifier Low / Median / High Price $234.04 / $273.97 / $435.86	Professional		$234.04	$273.97	$435.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.26 / $115.10 / $210.17	Professional		$36.26	$115.10	$210.17
United Facility/Professional Professional Modifier Low / Median / High Price $127.86 / $166.22 / $271.08	Professional		$127.86	$166.22	$271.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.36 / $48.57 / $80.70	Professional	26	$37.36	$48.57	$80.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.32 / $117.85 / $211.33	Professional	TC	$92.32	$117.85	$211.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $187.47 / $237.30 / $279.10	Professional		$187.47	$237.30	$279.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $52.61 / $66.59 / $78.30	Professional	26	$52.61	$66.59	$78.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $134.85 / $170.70 / $200.80	Professional	TC	$134.85	$170.70	$200.80