Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $242.40 / $930.17	Facility		$77.62	$242.40	$930.17
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.83 / $51.83 / $51.83	Facility	26	$51.83	$51.83	$51.83
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $56.95 / $337.05 / $966.93	Facility	TC	$56.95	$337.05	$966.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.56 / $211.20 / $984.98	Professional		$60.56	$211.20	$984.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.28 / $67.72 / $237.02	Professional	26	$27.28	$67.72	$237.02
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.93 / $30.28 / $33.76	Professional	52	$25.93	$30.28	$33.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.57 / $57.51 / $410.96	Professional	TC	$24.57	$57.51	$410.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.65 / $139.32 / $227.82	Professional		$65.65	$139.32	$227.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.34 / $69.83 / $114.99	Professional	26	$30.34	$69.83	$114.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.57 / $66.97 / $126.35	Professional	TC	$30.57	$66.97	$126.35
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.73 / $114.29 / $242.00	Professional		$67.73	$114.29	$242.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.77 / $59.26 / $137.66	Professional	26	$36.77	$59.26	$137.66
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.64 / $51.78 / $110.30	Professional	TC	$23.64	$51.78	$110.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.86 / $146.32 / $271.29	Facility		$79.86	$146.32	$271.29
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $163.47 / $163.47 / $163.47	Facility	26	$163.47	$163.47	$163.47
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $216.27 / $216.27 / $216.27	Facility	TC	$216.27	$216.27	$216.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.98 / $128.36 / $547.54	Professional		$66.98	$128.36	$547.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $75.95 / $292.24	Professional	26	$38.02	$75.95	$292.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.96 / $57.37 / $349.50	Professional	TC	$28.96	$57.37	$349.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $81.41 / $125.17 / $185.00	Facility		$81.41	$125.17	$185.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $139.31 / $139.31 / $139.31	Facility	26	$139.31	$139.31	$139.31
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $143.77 / $143.77 / $143.77	Facility	TC	$143.77	$143.77	$143.77
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.89 / $131.46 / $200.61	Professional		$83.89	$131.46	$200.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $62.80 / $121.12	Professional		$33.86	$62.80	$121.12
United Facility/Professional Professional Modifier Low / Median / High Price $66.98 / $68.98 / $182.90	Professional		$66.98	$68.98	$182.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.99 / $39.15 / $89.00	Professional	26	$37.99	$39.15	$89.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.96 / $29.83 / $200.67	Professional	TC	$28.96	$29.83	$200.67
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $122.00 / $143.50 / $168.80	Professional		$122.00	$143.50	$168.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $61.30 / $72.09 / $84.80	Professional	26	$61.30	$72.09	$84.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $60.70 / $71.40 / $84.00	Professional	TC	$60.70	$71.40	$84.00