Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $159.52 / $322.47 / $596.41	Facility	26	$159.52	$322.47	$596.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $829.09 / $1,376.38 / $4,963.22	Professional		$829.09	$1,376.38	$4,963.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $735.39 / $1,233.61 / $4,394.97	Professional	TC	$735.39	$1,233.61	$4,394.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $358.11 / $368.85 / $379.60	Facility	26	$358.11	$368.85	$379.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,371.19 / $2,216.94 / $2,771.19	Professional		$1,371.19	$2,216.94	$2,771.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,143.92 / $2,002.08 / $2,502.60	Professional	TC	$1,143.92	$2,002.08	$2,502.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $425.74 / $924.17 / $1,932.75	Professional		$425.74	$924.17	$1,932.75
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $92.24 / $147.22 / $271.57	Professional	26	$92.24	$147.22	$271.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $242.88 / $826.43 / $1,648.24	Professional	TC	$242.88	$826.43	$1,648.24
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $368.85 / $368.85 / $368.85	Facility	26	$368.85	$368.85	$368.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $549.90 / $1,153.83 / $2,718.47	Professional		$549.90	$1,153.83	$2,718.47
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $600.49 / $896.55 / $5,800.59	Professional	TC	$600.49	$896.55	$5,800.59
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $368.85 / $379.60 / $527.76	Facility	26	$368.85	$379.60	$527.76
Midlands Facility/Professional Professional Modifier Low / Median / High Price $923.64 / $1,719.12 / $2,588.13	Professional		$923.64	$1,719.12	$2,588.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $108.28 / $843.05 / $1,686.93	Professional		$108.28	$843.05	$1,686.93
United Facility/Professional Professional Modifier Low / Median / High Price $736.23 / $990.98 / $1,516.02	Professional		$736.23	$990.98	$1,516.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $656.17 / $886.38 / $1,342.93	Professional	TC	$656.17	$886.38	$1,342.93
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,372.86 / $1,737.80 / $2,044.50	Professional		$1,372.86	$1,737.80	$2,044.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $1,227.82 / $1,554.20 / $1,828.40	Professional	TC	$1,227.82	$1,554.20	$1,828.40