Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.70 / $138.63 / $375.64	Facility	26	$67.70	$138.63	$375.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $379.68 / $390.57 / $3,039.89	Professional		$379.68	$390.57	$3,039.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.25 / $72.97 / $412.72	Professional	26	$69.25	$72.97	$412.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $309.14 / $317.61 / $2,594.48	Professional	TC	$309.14	$317.61	$2,594.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $232.55 / $239.53 / $246.50	Facility	26	$232.55	$239.53	$246.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $894.12 / $918.43 / $1,148.04	Professional		$894.12	$918.43	$1,148.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $154.41 / $166.00 / $207.50	Professional	26	$154.41	$166.00	$207.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $735.58 / $752.43 / $940.54	Professional	TC	$735.58	$752.43	$940.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $337.55 / $524.99 / $1,823.61	Professional		$337.55	$524.99	$1,823.61
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.98 / $109.37 / $247.31	Professional	26	$67.98	$109.37	$247.31
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $269.55 / $461.70 / $1,137.08	Professional	TC	$269.55	$461.70	$1,137.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $239.53 / $239.53 / $239.53	Facility	26	$239.53	$239.53	$239.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $378.49 / $541.45 / $1,292.29	Professional		$378.49	$541.45	$1,292.29
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $75.68 / $90.82 / $281.27	Professional	26	$75.68	$90.82	$281.27
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $295.67 / $382.75 / $1,011.02	Professional	TC	$295.67	$382.75	$1,011.02
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $239.53 / $246.50 / $406.80	Facility	26	$239.53	$246.50	$406.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $512.77 / $830.46 / $1,187.58	Professional		$512.77	$830.46	$1,187.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.91 / $356.92 / $637.10	Professional		$72.91	$356.92	$637.10
United Facility/Professional Professional Modifier Low / Median / High Price $388.19 / $484.30 / $812.78	Professional		$388.19	$484.30	$812.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.68 / $87.03 / $146.06	Professional	26	$75.68	$87.03	$146.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $295.37 / $382.75 / $767.93	Professional	TC	$295.37	$382.75	$767.93
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $526.38 / $666.30 / $783.90	Professional		$526.38	$666.30	$783.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $97.88 / $123.90 / $145.80	Professional	26	$97.88	$123.90	$145.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $428.50 / $542.40 / $638.10	Professional	TC	$428.50	$542.40	$638.10