Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.92 / $302.33 / $521.88	Facility	26	$99.92	$302.33	$521.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.59 / $224.88 / $764.42	Professional		$154.59	$224.88	$764.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.45 / $168.19 / $614.97	Professional	26	$98.45	$168.19	$614.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.57 / $87.15 / $175.40	Professional	TC	$29.57	$87.15	$175.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $327.20 / $337.02 / $346.83	Facility	26	$327.20	$337.02	$346.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $283.05 / $340.53 / $425.67	Professional		$283.05	$340.53	$425.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $214.19 / $248.22 / $310.27	Professional	26	$214.19	$248.22	$310.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.78 / $92.31 / $115.39	Professional	TC	$65.78	$92.31	$115.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $133.01 / $242.87 / $1,133.44	Professional		$133.01	$242.87	$1,133.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $99.80 / $162.62 / $808.38	Professional	26	$99.80	$162.62	$808.38
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.21 / $62.01 / $666.65	Professional	TC	$33.21	$62.01	$666.65
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $337.02 / $337.02 / $337.02	Facility	26	$337.02	$337.02	$337.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $148.50 / $284.32 / $1,878.07	Professional		$148.50	$284.32	$1,878.07
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $116.31 / $140.00 / $1,056.82	Professional	26	$116.31	$140.00	$1,056.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.73 / $43.44 / $2,488.46	Professional	TC	$25.73	$43.44	$2,488.46
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $337.02 / $346.83 / $595.14	Facility	26	$337.02	$346.83	$595.14
Midlands Facility/Professional Professional Modifier Low / Median / High Price $270.31 / $312.76 / $799.00	Professional		$270.31	$312.76	$799.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.36 / $105.93 / $247.83	Professional		$39.36	$105.93	$247.83
United Facility/Professional Professional Modifier Low / Median / High Price $142.04 / $168.15 / $324.60	Professional		$142.04	$168.15	$324.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $116.31 / $137.69 / $204.08	Professional	26	$116.31	$137.69	$204.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.73 / $30.91 / $169.20	Professional	TC	$25.73	$30.91	$169.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $214.25 / $271.20 / $319.00	Professional		$214.25	$271.20	$319.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $157.21 / $199.00 / $234.20	Professional	26	$157.21	$199.00	$234.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $56.96 / $72.09 / $84.80	Professional	TC	$56.96	$72.09	$84.80