Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $142.68 / $431.83 / $724.94	Facility	26	$142.68	$431.83	$724.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.62 / $417.96 / $1,672.38	Professional		$252.62	$417.96	$1,672.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.81 / $235.59 / $835.00	Professional	26	$131.81	$235.59	$835.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.19 / $190.68 / $797.39	Professional	TC	$123.19	$190.68	$797.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $477.54 / $491.87 / $506.19	Facility	26	$477.54	$491.87	$506.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $567.34 / $681.06 / $851.33	Professional		$567.34	$681.06	$851.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $305.44 / $354.49 / $443.12	Professional	26	$305.44	$354.49	$443.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $261.92 / $326.57 / $408.21	Professional	TC	$261.92	$326.57	$408.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $290.80 / $403.88 / $1,289.13	Professional		$290.80	$403.88	$1,289.13
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $156.94 / $219.78 / $629.99	Professional	26	$156.94	$219.78	$629.99
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $135.19 / $186.68 / $439.05	Professional	TC	$135.19	$186.68	$439.05
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $491.87 / $491.87 / $491.87	Facility	26	$491.87	$491.87	$491.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $302.89 / $413.04 / $1,040.72	Professional		$302.89	$413.04	$1,040.72
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $165.59 / $196.02 / $617.64	Professional	26	$165.59	$196.02	$617.64
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $137.31 / $166.55 / $686.39	Professional	TC	$137.31	$166.55	$686.39
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $491.87 / $506.19 / $848.94	Facility	26	$491.87	$506.19	$848.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $517.11 / $623.39 / $991.76	Professional		$517.11	$623.39	$991.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $138.28 / $263.25 / $486.54	Professional		$138.28	$263.25	$486.54
United Facility/Professional Professional Modifier Low / Median / High Price $302.89 / $358.57 / $539.29	Professional		$302.89	$358.57	$539.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $165.59 / $189.80 / $290.52	Professional	26	$165.59	$189.80	$290.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $137.31 / $162.55 / $542.21	Professional	TC	$137.31	$162.55	$542.21
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $426.44 / $539.79 / $635.10	Professional		$426.44	$539.79	$635.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $224.91 / $284.70 / $334.90	Professional	26	$224.91	$284.70	$334.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $201.53 / $255.10 / $300.10	Professional	TC	$201.53	$255.10	$300.10