Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $130.61 / $130.61 / $130.61	Facility	26	$130.61	$130.61	$130.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $729.78 / $729.78 / $6,377.29	Professional		$729.78	$729.78	$6,377.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.13 / $87.13 / $591.17	Professional	26	$87.13	$87.13	$591.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $642.65 / $642.65 / $5,786.06	Professional	TC	$642.65	$642.65	$5,786.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $282.58 / $291.07 / $299.55	Facility	26	$282.58	$291.07	$299.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,710.04 / $1,895.04 / $2,368.79	Professional		$1,710.04	$1,895.04	$2,368.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $203.52 / $218.75 / $273.43	Professional	26	$203.52	$218.75	$273.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,506.52 / $1,676.29 / $2,095.36	Professional	TC	$1,506.52	$1,676.29	$2,095.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $783.95 / $1,175.92 / $4,472.07	Professional		$783.95	$1,175.92	$4,472.07
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $98.46 / $147.26 / $461.99	Professional	26	$98.46	$147.26	$461.99
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $692.64 / $1,028.66 / $3,046.47	Professional	TC	$692.64	$1,028.66	$3,046.47
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $291.07 / $291.07 / $291.07	Facility	26	$291.07	$291.07	$291.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $870.75 / $1,129.08 / $3,238.49	Professional		$870.75	$1,129.08	$3,238.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $99.80 / $115.54 / $354.66	Professional	26	$99.80	$115.54	$354.66
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $770.28 / $924.34 / $2,883.83	Professional	TC	$770.28	$924.34	$2,883.83
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $291.07 / $299.55 / $535.38	Facility	26	$291.07	$299.55	$535.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,547.38 / $1,848.45 / $3,133.22	Professional		$1,547.38	$1,848.45	$3,133.22
United Facility/Professional Professional Modifier Low / Median / High Price $870.75 / $957.83 / $1,680.55	Professional		$870.75	$957.83	$1,680.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.43 / $115.54 / $193.91	Professional	26	$99.43	$115.54	$193.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $762.64 / $885.82 / $2,407.69	Professional	TC	$762.64	$885.82	$2,407.69
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,083.88 / $1,372.00 / $1,614.10	Professional		$1,083.88	$1,372.00	$1,614.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $129.01 / $163.30 / $192.10	Professional	26	$129.01	$163.30	$192.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $954.87 / $1,208.70 / $1,422.00	Professional	TC	$954.87	$1,208.70	$1,422.00