Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $150.56 / $289.14 / $535.07	Facility	26	$150.56	$289.14	$535.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.84 / $129.84 / $857.00	Professional		$129.84	$129.84	$857.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.73 / $45.59 / $298.89	Professional	TC	$44.73	$45.59	$298.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $318.06 / $327.60 / $337.14	Facility	26	$318.06	$327.60	$337.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $289.69 / $338.21 / $422.76	Professional		$289.69	$338.21	$422.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.95 / $126.44 / $158.05	Professional	TC	$102.95	$126.44	$158.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $131.58 / $219.62 / $537.85	Professional		$131.58	$219.62	$537.85
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.88 / $141.63 / $327.62	Professional	26	$85.88	$141.63	$327.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.70 / $80.88 / $267.85	Professional	TC	$45.70	$80.88	$267.85
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $327.60 / $327.60 / $327.60	Facility	26	$327.60	$327.60	$327.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $148.53 / $235.02 / $703.01	Professional		$148.53	$235.02	$703.01
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $47.87 / $61.59 / $585.04	Professional	TC	$47.87	$61.59	$585.04
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $327.60 / $337.14 / $518.94	Facility	26	$327.60	$337.14	$518.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $237.69 / $316.07 / $423.73	Professional		$237.69	$316.07	$423.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.92 / $105.11 / $244.38	Professional		$53.92	$105.11	$244.38
United Facility/Professional Professional Modifier Low / Median / High Price $143.30 / $173.95 / $288.58	Professional		$143.30	$173.95	$288.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.87 / $60.93 / $104.01	Professional	TC	$47.87	$60.93	$104.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $196.63 / $248.90 / $292.89	Professional		$196.63	$248.90	$292.89
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $72.59 / $91.90 / $108.10	Professional	TC	$72.59	$91.90	$108.10