Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.96 / $68.36 / $207.18	Facility	26	$36.96	$68.36	$207.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $237.86 / $283.07 / $1,341.00	Professional		$237.86	$283.07	$1,341.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.97 / $38.46 / $92.92	Professional	26	$35.97	$38.46	$92.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $201.88 / $217.56 / $1,814.51	Professional	TC	$201.88	$217.56	$1,814.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.66 / $129.43 / $133.19	Facility	26	$125.66	$129.43	$133.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $563.60 / $622.89 / $778.61	Professional		$563.60	$622.89	$778.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.68 / $90.76 / $113.45	Professional	26	$84.68	$90.76	$113.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $478.92 / $532.13 / $665.16	Professional	TC	$478.92	$532.13	$665.16
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $228.19 / $355.95 / $613.19	Professional		$228.19	$355.95	$613.19
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.22 / $61.00 / $116.80	Professional	26	$37.22	$61.00	$116.80
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $190.96 / $298.70 / $497.45	Professional	TC	$190.96	$298.70	$497.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $129.43 / $129.43 / $129.43	Facility	26	$129.43	$129.43	$129.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $242.37 / $376.00 / $893.00	Professional		$242.37	$376.00	$893.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.62 / $47.87 / $165.83	Professional	26	$41.62	$47.87	$165.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $179.89 / $277.93 / $727.17	Professional	TC	$179.89	$277.93	$727.17
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $129.43 / $133.19 / $221.82	Facility	26	$129.43	$133.19	$221.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $378.00 / $536.44 / $729.93	Professional		$378.00	$536.44	$729.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $240.82 / $453.88	Professional		$39.86	$240.82	$453.88
United Facility/Professional Professional Modifier Low / Median / High Price $242.37 / $311.63 / $546.77	Professional		$242.37	$311.63	$546.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.49 / $49.94 / $84.48	Professional	26	$41.49	$49.94	$84.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $205.43 / $265.85 / $492.62	Professional	TC	$205.43	$265.85	$492.62
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $357.24 / $452.20 / $532.00	Professional		$357.24	$452.20	$532.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $53.64 / $67.90 / $79.90	Professional	26	$53.64	$67.90	$79.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $303.52 / $384.20 / $452.10	Professional	TC	$303.52	$384.20	$452.10