Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.92 / $81.20 / $246.59	Facility	26	$43.92	$81.20	$246.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $278.75 / $300.13 / $1,856.00	Professional		$278.75	$300.13	$1,856.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.74 / $45.91 / $243.62	Professional	26	$42.74	$45.91	$243.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $236.01 / $236.01 / $2,077.76	Professional	TC	$236.01	$236.01	$2,077.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $148.94 / $153.41 / $157.88	Facility	26	$148.94	$153.41	$157.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $661.80 / $732.26 / $915.33	Professional		$661.80	$732.26	$915.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.34 / $107.82 / $134.78	Professional	26	$100.34	$107.82	$134.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $561.46 / $624.44 / $780.55	Professional	TC	$561.46	$624.44	$780.55
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $267.98 / $417.93 / $779.26	Professional		$267.98	$417.93	$779.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.10 / $72.47 / $115.50	Professional	26	$44.10	$72.47	$115.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.88 / $350.27 / $643.11	Professional	TC	$223.88	$350.27	$643.11
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $153.41 / $153.41 / $153.41	Facility	26	$153.41	$153.41	$153.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $304.00 / $426.08 / $1,052.86	Professional		$304.00	$426.08	$1,052.86
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $49.36 / $56.76 / $196.25	Professional	26	$49.36	$56.76	$196.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $245.28 / $318.22 / $879.31	Professional	TC	$245.28	$318.22	$879.31
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $153.41 / $157.88 / $264.66	Facility	26	$153.41	$157.88	$264.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $432.64 / $661.80 / $826.14	Professional		$432.64	$661.80	$826.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.42 / $281.94 / $503.26	Professional		$47.42	$281.94	$503.26
United Facility/Professional Professional Modifier Low / Median / High Price $297.08 / $358.68 / $657.43	Professional		$297.08	$358.68	$657.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.01 / $55.50 / $99.88	Professional	26	$49.01	$55.50	$99.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $260.13 / $304.38 / $564.05	Professional	TC	$260.13	$304.38	$564.05
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $419.49 / $531.00 / $624.70	Professional		$419.49	$531.00	$624.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $63.60 / $80.50 / $94.70	Professional	26	$63.60	$80.50	$94.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $355.90 / $450.50 / $530.00	Professional	TC	$355.90	$450.50	$530.00