Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.89 / $107.04 / $174.35	Facility	26	$34.89	$107.04	$174.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.22 / $387.81 / $1,263.55	Professional		$171.22	$387.81	$1,263.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.89 / $77.23 / $182.00	Professional	26	$34.89	$77.23	$182.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.00 / $331.47 / $1,154.00	Professional	TC	$168.00	$331.47	$1,154.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.81 / $112.07 / $115.34	Facility	26	$108.81	$112.07	$115.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $491.23 / $635.29 / $794.12	Professional		$491.23	$635.29	$794.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.40 / $86.88 / $108.60	Professional	26	$75.40	$86.88	$108.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $401.53 / $548.41 / $685.52	Professional	TC	$401.53	$548.41	$685.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $230.92 / $305.00 / $530.47	Professional		$230.92	$305.00	$530.47
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.88 / $57.00 / $204.93	Professional	26	$34.88	$57.00	$204.93
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $196.05 / $244.96 / $402.80	Professional	TC	$196.05	$244.96	$402.80
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $112.07 / $112.07 / $112.07	Facility	26	$112.07	$112.07	$112.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $219.82 / $362.44 / $865.30	Professional		$219.82	$362.44	$865.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.54 / $48.36 / $719.00	Professional	26	$40.54	$48.36	$719.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $165.31 / $288.77 / $1,676.00	Professional	TC	$165.31	$288.77	$1,676.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $112.07 / $115.34 / $209.58	Facility	26	$112.07	$115.34	$209.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $305.00 / $566.28 / $724.19	Professional		$305.00	$566.28	$724.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.86 / $214.24 / $442.45	Professional		$37.86	$214.24	$442.45
United Facility/Professional Professional Modifier Low / Median / High Price $227.42 / $336.76 / $522.41	Professional		$227.42	$336.76	$522.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.54 / $47.99 / $129.80	Professional	26	$40.54	$47.99	$129.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $183.21 / $288.77 / $452.25	Professional	TC	$183.21	$288.77	$452.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $391.45 / $495.50 / $582.90	Professional		$391.45	$495.50	$582.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $54.98 / $69.59 / $81.90	Professional	26	$54.98	$69.59	$81.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $336.38 / $425.80 / $501.00	Professional	TC	$336.38	$425.80	$501.00