Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.81 / $71.83 / $135.37	Facility	26	$37.81	$71.83	$135.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $350.52 / $635.44 / $2,306.00	Professional		$350.52	$635.44	$2,306.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.81 / $62.21 / $219.12	Professional	26	$37.81	$62.21	$219.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $312.70 / $433.43 / $1,135.16	Professional	TC	$312.70	$433.43	$1,135.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.66 / $132.52 / $136.38	Facility	26	$128.66	$132.52	$136.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $831.18 / $921.53 / $1,151.91	Professional		$831.18	$921.53	$1,151.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.95 / $95.41 / $119.26	Professional	26	$88.95	$95.41	$119.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $742.21 / $826.12 / $1,032.65	Professional	TC	$742.21	$826.12	$1,032.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $335.03 / $506.03 / $957.27	Professional		$335.03	$506.03	$957.27
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.09 / $56.94 / $144.57	Professional	26	$39.09	$56.94	$144.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $295.95 / $462.90 / $856.59	Professional	TC	$295.95	$462.90	$856.59
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $132.52 / $132.52 / $132.52	Facility	26	$132.52	$132.52	$132.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $415.83 / $541.49 / $1,361.45	Professional		$415.83	$541.49	$1,361.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $43.54 / $50.28 / $151.66	Professional	26	$43.54	$50.28	$151.66
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $372.11 / $446.53 / $1,463.91	Professional	TC	$372.11	$446.53	$1,463.91
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $132.52 / $136.38 / $233.28	Facility	26	$132.52	$136.38	$233.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $682.60 / $878.37 / $1,180.27	Professional		$682.60	$878.37	$1,180.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.97 / $354.55 / $633.03	Professional		$41.97	$354.55	$633.03
United Facility/Professional Professional Modifier Low / Median / High Price $415.83 / $478.20 / $841.29	Professional		$415.83	$478.20	$841.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.72 / $52.47 / $84.38	Professional	26	$43.72	$52.47	$84.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $372.11 / $427.92 / $758.61	Professional	TC	$372.11	$427.92	$758.61
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $526.85 / $666.90 / $784.50	Professional		$526.85	$666.90	$784.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $56.41 / $71.40 / $84.00	Professional	26	$56.41	$71.40	$84.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $470.45 / $595.50 / $700.60	Professional	TC	$470.45	$595.50	$700.60