Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.97 / $204.87 / $379.09	Facility	26	$85.97	$204.87	$379.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $273.75 / $294.70 / $2,282.58	Professional		$273.75	$294.70	$2,282.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.53 / $60.68 / $446.16	Professional	26	$57.53	$60.68	$446.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $216.22 / $216.22 / $1,893.25	Professional	TC	$216.22	$216.22	$1,893.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $200.24 / $206.25 / $212.25	Facility	26	$200.24	$206.25	$212.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $653.27 / $722.18 / $902.72	Professional		$653.27	$722.18	$902.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.49 / $145.06 / $181.32	Professional	26	$134.49	$145.06	$181.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $518.78 / $577.12 / $721.40	Professional	TC	$518.78	$577.12	$721.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $266.00 / $412.60 / $1,037.04	Professional		$266.00	$412.60	$1,037.04
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.15 / $90.44 / $195.00	Professional	26	$59.15	$90.44	$195.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $206.85 / $354.26 / $616.37	Professional	TC	$206.85	$354.26	$616.37
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $206.25 / $206.25 / $206.25	Facility	26	$206.25	$206.25	$206.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $318.11 / $457.98 / $1,039.29	Professional		$318.11	$457.98	$1,039.29
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $65.95 / $85.88 / $320.29	Professional	26	$65.95	$85.88	$320.29
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $252.16 / $328.36 / $1,199.18	Professional	TC	$252.16	$328.36	$1,199.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $206.25 / $212.25 / $357.00	Facility	26	$206.25	$212.25	$357.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $453.30 / $686.82 / $857.74	Professional		$453.30	$686.82	$857.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.11 / $286.94 / $1,424.25	Professional		$63.11	$286.94	$1,424.25
United Facility/Professional Professional Modifier Low / Median / High Price $318.11 / $365.83 / $638.73	Professional		$318.11	$365.83	$638.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.95 / $79.14 / $127.28	Professional	26	$65.95	$79.14	$127.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $252.16 / $302.58 / $513.98	Professional	TC	$252.16	$302.58	$513.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $414.04 / $524.10 / $616.60	Professional		$414.04	$524.10	$616.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $85.24 / $107.90 / $127.00	Professional	26	$85.24	$107.90	$127.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $328.80 / $416.20 / $489.70	Professional	TC	$328.80	$416.20	$489.70