Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.31 / $97.45 / $191.19	Professional		$84.31	$97.45	$191.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.48 / $75.05 / $312.06	Professional	26	$64.48	$75.05	$312.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.82 / $23.57 / $61.21	Professional	TC	$19.82	$23.57	$61.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.90 / $206.55 / $294.74	Professional		$78.90	$206.55	$294.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.20 / $153.00 / $220.78	Professional	26	$55.20	$153.00	$220.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.70 / $53.69 / $119.61	Professional	TC	$23.70	$53.69	$119.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $94.12 / $188.09 / $298.75	Professional		$94.12	$188.09	$298.75
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $78.73 / $126.95 / $300.75	Professional	26	$78.73	$126.95	$300.75
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.38 / $46.25 / $108.28	Professional	TC	$15.38	$46.25	$108.28
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $390.55 / $390.55 / $390.55	Facility	26	$390.55	$390.55	$390.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $112.33 / $202.63 / $745.14	Professional		$112.33	$202.63	$745.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $83.75 / $136.43 / $538.00	Professional	26	$83.75	$136.43	$538.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.05 / $49.37 / $340.13	Professional	TC	$24.05	$49.37	$340.13
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $217.63 / $217.63 / $217.63	Facility	26	$217.63	$217.63	$217.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $137.27 / $206.55 / $289.44	Professional		$137.27	$206.55	$289.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.31 / $108.32 / $199.20	Professional		$30.31	$108.32	$199.20
United Facility/Professional Professional Modifier Low / Median / High Price $112.33 / $115.70 / $272.45	Professional		$112.33	$115.70	$272.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.22 / $90.93 / $206.66	Professional	26	$88.22	$90.93	$206.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.05 / $25.74 / $58.33	Professional	TC	$24.05	$25.74	$58.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $197.40 / $232.30 / $273.20	Professional		$197.40	$232.30	$273.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $146.40 / $172.20 / $202.50	Professional	26	$146.40	$172.20	$202.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $51.10 / $60.10 / $70.70	Professional	TC	$51.10	$60.10	$70.70