Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.18 / $85.38 / $255.94	Facility	26	$46.18	$85.38	$255.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $306.76 / $393.21 / $1,800.00	Professional		$306.76	$393.21	$1,800.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.94 / $48.13 / $234.96	Professional	26	$44.94	$48.13	$234.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $261.82 / $261.82 / $2,360.71	Professional	TC	$261.82	$261.82	$2,360.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.94 / $159.60 / $164.25	Facility	26	$154.94	$159.60	$164.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $721.58 / $798.97 / $998.71	Professional		$721.58	$798.97	$998.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.31 / $113.25 / $141.57	Professional	26	$105.31	$113.25	$141.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $616.26 / $685.72 / $857.15	Professional	TC	$616.26	$685.72	$857.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $292.08 / $488.01 / $1,844.84	Professional		$292.08	$488.01	$1,844.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.37 / $76.20 / $243.48	Professional	26	$46.37	$76.20	$243.48
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $245.71 / $391.88 / $1,551.10	Professional	TC	$245.71	$391.88	$1,551.10
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $159.60 / $159.60 / $159.60	Facility	26	$159.60	$159.60	$159.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $332.55 / $525.73 / $1,236.43	Professional		$332.55	$525.73	$1,236.43
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.56 / $59.64 / $211.47	Professional	26	$51.56	$59.64	$211.47
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $261.75 / $361.50 / $1,326.53	Professional	TC	$261.75	$361.50	$1,326.53
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $159.60 / $164.25 / $278.39	Facility	26	$159.60	$164.25	$278.39
Midlands Facility/Professional Professional Modifier Low / Median / High Price $548.00 / $721.58 / $1,036.38	Professional		$548.00	$721.58	$1,036.38
United Facility/Professional Professional Modifier Low / Median / High Price $338.89 / $402.50 / $813.42	Professional		$338.89	$402.50	$813.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.56 / $59.30 / $99.51	Professional	26	$51.56	$59.30	$99.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $285.17 / $359.09 / $606.70	Professional	TC	$285.17	$359.09	$606.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $457.33 / $578.90 / $681.10	Professional		$457.33	$578.90	$681.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $66.76 / $84.50 / $99.40	Professional	26	$66.76	$84.50	$99.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $390.58 / $494.40 / $581.70	Professional	TC	$390.58	$494.40	$581.70