Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.92 / $76.41 / $85.19	Professional		$64.92	$76.41	$85.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.18 / $17.47 / $19.48	Professional	26	$15.18	$17.47	$19.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.74 / $58.94 / $65.70	Professional	TC	$49.74	$58.94	$65.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.55 / $158.24 / $231.79	Professional		$44.55	$158.24	$231.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.46 / $40.86 / $68.61	Professional	26	$18.46	$40.86	$68.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.52 / $119.77 / $180.15	Professional	TC	$23.52	$119.77	$180.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $49.09 / $128.69 / $230.37	Professional		$49.09	$128.69	$230.37
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.21 / $36.38 / $97.91	Professional	26	$21.21	$36.38	$97.91
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $12.71 / $88.80 / $166.69	Professional	TC	$12.71	$88.80	$166.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.18 / $149.63 / $626.79	Professional		$80.18	$149.63	$626.79
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.18 / $34.65 / $171.71	Professional	26	$22.18	$34.65	$171.71
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $61.61 / $107.22 / $496.32	Professional	TC	$61.61	$107.22	$496.32
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $58.76 / $58.76 / $58.76	Facility	26	$58.76	$58.76	$58.76
Midlands Facility/Professional Professional Modifier Low / Median / High Price $91.45 / $154.50 / $221.32	Professional		$91.45	$154.50	$221.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.23 / $76.72 / $142.61	Professional		$19.23	$76.72	$142.61
United Facility/Professional Professional Modifier Low / Median / High Price $90.52 / $93.24 / $207.67	Professional		$90.52	$93.24	$207.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.25 / $22.96 / $52.18	Professional	26	$22.25	$22.96	$52.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.59 / $70.28 / $143.86	Professional	TC	$64.59	$70.28	$143.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $145.80 / $171.50 / $201.70	Professional		$145.80	$171.50	$201.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $32.90 / $38.70 / $45.50	Professional	26	$32.90	$38.70	$45.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $112.90 / $132.80 / $156.19	Professional	TC	$112.90	$132.80	$156.19