Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.20 / $297.55 / $499.06	Facility	26	$98.20	$297.55	$499.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $385.68 / $597.28 / $2,638.87	Professional		$385.68	$597.28	$2,638.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.12 / $202.04 / $545.00	Professional	26	$95.12	$202.04	$545.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $285.00 / $440.67 / $2,031.95	Professional	TC	$285.00	$440.67	$2,031.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $349.46 / $359.94 / $370.43	Facility	26	$349.46	$359.94	$370.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $797.01 / $951.01 / $1,188.76	Professional		$797.01	$951.01	$1,188.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $211.12 / $244.35 / $305.43	Professional	26	$211.12	$244.35	$305.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $585.91 / $706.66 / $883.33	Professional	TC	$585.91	$706.66	$883.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $350.76 / $522.50 / $1,380.45	Professional		$350.76	$522.50	$1,380.45
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.96 / $137.94 / $344.97	Professional	26	$97.96	$137.94	$344.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $252.79 / $394.95 / $744.10	Professional	TC	$252.79	$394.95	$744.10
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $359.94 / $359.94 / $359.94	Facility	26	$359.94	$359.94	$359.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $464.88 / $654.36 / $1,520.53	Professional		$464.88	$654.36	$1,520.53
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $114.76 / $135.86 / $425.44	Professional	26	$114.76	$135.86	$425.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $350.12 / $414.48 / $1,674.04	Professional	TC	$350.12	$414.48	$1,674.04
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $359.94 / $370.43 / $586.86	Facility	26	$359.94	$370.43	$586.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $726.75 / $883.81 / $1,367.63	Professional		$726.75	$883.81	$1,367.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $103.64 / $306.38 / $663.06	Professional		$103.64	$306.38	$663.06
United Facility/Professional Professional Modifier Low / Median / High Price $464.88 / $540.95 / $815.66	Professional		$464.88	$540.95	$815.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $111.10 / $135.86 / $201.36	Professional	26	$111.10	$135.86	$201.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $318.76 / $414.48 / $649.03	Professional	TC	$318.76	$414.48	$649.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $588.08 / $744.40 / $875.80	Professional		$588.08	$744.40	$875.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $154.37 / $195.40 / $229.80	Professional	26	$154.37	$195.40	$229.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $433.79 / $549.10 / $646.00	Professional	TC	$433.79	$549.10	$646.00