Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.53 / $92.70 / $154.99	Facility	26	$30.53	$92.70	$154.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.40 / $361.00 / $2,214.05	Professional		$62.40	$361.00	$2,214.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.59 / $210.66 / $986.67	Professional	26	$45.59	$210.66	$986.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.34 / $63.06 / $940.00	Professional	TC	$35.34	$63.06	$940.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.13 / $101.07 / $104.02	Facility	26	$98.13	$101.07	$104.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.93 / $156.69 / $195.86	Professional		$129.93	$156.69	$195.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.26 / $76.02 / $95.02	Professional	26	$65.26	$76.02	$95.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.69 / $80.67 / $100.84	Professional	TC	$64.69	$80.67	$100.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $59.82 / $101.72 / $221.82	Professional		$59.82	$101.72	$221.82
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.59 / $50.10 / $168.49	Professional	26	$30.59	$50.10	$168.49
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.23 / $49.95 / $79.87	Professional	TC	$29.23	$49.95	$79.87
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $101.07 / $101.07 / $101.07	Facility	26	$101.07	$101.07	$101.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.50 / $116.23 / $309.52	Professional		$72.50	$116.23	$309.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.39 / $43.14 / $378.10	Professional	26	$35.39	$43.14	$378.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $34.02 / $46.39 / $378.10	Professional	TC	$34.02	$46.39	$378.10
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $101.07 / $104.02 / $181.26	Facility	26	$101.07	$104.02	$181.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $124.28 / $143.75 / $192.59	Professional		$124.28	$143.75	$192.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.63 / $60.62 / $112.01	Professional		$31.63	$60.62	$112.01
United Facility/Professional Professional Modifier Low / Median / High Price $69.41 / $84.86 / $124.25	Professional		$69.41	$84.86	$124.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.39 / $41.89 / $62.09	Professional	26	$35.39	$41.89	$62.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.02 / $42.13 / $63.68	Professional	TC	$34.02	$42.13	$63.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $98.36 / $124.50 / $146.40	Professional		$98.36	$124.50	$146.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $48.19 / $61.00 / $71.80	Professional	26	$48.19	$61.00	$71.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $50.17 / $63.50 / $74.70	Professional	TC	$50.17	$63.50	$74.70