Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $299.27 / $352.80 / $393.35	Professional		$299.27	$352.80	$393.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.35 / $40.70 / $45.38	Professional	26	$35.35	$40.70	$45.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.92 / $312.10 / $347.97	Professional	TC	$263.92	$312.10	$347.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $317.95 / $795.03 / $1,114.34	Professional		$317.95	$795.03	$1,114.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.42 / $82.10 / $123.55	Professional	26	$37.42	$82.10	$123.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $280.52 / $721.11 / $1,010.59	Professional	TC	$280.52	$721.11	$1,010.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $348.98 / $632.35 / $869.99	Professional		$348.98	$632.35	$869.99
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.00 / $77.28 / $174.72	Professional	26	$44.00	$77.28	$174.72
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $304.98 / $555.07 / $819.30	Professional	TC	$304.98	$555.07	$819.30
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $213.45 / $213.45 / $213.45	Facility	26	$213.45	$213.45	$213.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $411.34 / $707.99 / $2,779.34	Professional		$411.34	$707.99	$2,779.34
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $49.08 / $50.89 / $306.82	Professional	26	$49.08	$50.89	$306.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $340.64 / $399.51 / $2,481.83	Professional	TC	$340.64	$399.51	$2,481.83
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $122.74 / $122.74 / $122.74	Facility	26	$122.74	$122.74	$122.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $498.78 / $795.03 / $1,114.09	Professional		$498.78	$795.03	$1,114.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $46.80 / $366.37 / $670.76	Professional		$46.80	$366.37	$670.76
United Facility/Professional Professional Modifier Low / Median / High Price $411.34 / $423.68 / $997.66	Professional		$411.34	$423.68	$997.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.08 / $50.63 / $115.09	Professional	26	$49.08	$50.63	$115.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $362.18 / $373.05 / $878.43	Professional	TC	$362.18	$373.05	$878.43
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $689.90 / $811.70 / $954.60	Professional		$689.90	$811.70	$954.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $80.00 / $94.10 / $110.70	Professional	26	$80.00	$94.10	$110.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $609.90 / $717.60 / $843.90	Professional	TC	$609.90	$717.60	$843.90