Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.57 / $100.13 / $111.64	Professional		$85.57	$100.13	$111.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.26 / $36.99 / $139.94	Professional	26	$32.26	$36.99	$139.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.30 / $63.15 / $70.41	Professional	TC	$53.30	$63.15	$70.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.50 / $228.17 / $361.81	Professional		$106.50	$228.17	$361.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.96 / $84.24 / $134.15	Professional	26	$41.96	$84.24	$134.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.54 / $143.93 / $227.66	Professional	TC	$64.54	$143.93	$227.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $116.39 / $183.51 / $381.59	Professional		$116.39	$183.51	$381.59
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.11 / $69.18 / $191.09	Professional	26	$43.11	$69.18	$191.09
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $73.29 / $114.47 / $191.09	Professional	TC	$73.29	$114.47	$191.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $237.42 / $237.42 / $237.42	Facility	26	$237.42	$237.42	$237.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.02 / $225.94 / $881.27	Professional		$120.02	$225.94	$881.27
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $45.24 / $73.65 / $342.38	Professional	26	$45.24	$73.65	$342.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $74.78 / $121.74 / $549.40	Professional	TC	$74.78	$121.74	$549.40
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $149.87 / $149.87 / $149.87	Facility	26	$149.87	$149.87	$149.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $152.53 / $228.17 / $314.08	Professional		$152.53	$228.17	$314.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.13 / $106.12 / $193.89	Professional		$41.13	$106.12	$193.89
United Facility/Professional Professional Modifier Low / Median / High Price $120.02 / $129.19 / $316.33	Professional		$120.02	$129.19	$316.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.24 / $46.56 / $109.73	Professional	26	$45.24	$46.56	$109.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.78 / $77.02 / $302.76	Professional	TC	$74.78	$77.02	$302.76
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $196.90 / $231.60 / $272.39	Professional		$196.90	$231.60	$272.39
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $70.90 / $83.40 / $98.10	Professional	26	$70.90	$83.40	$98.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $126.00 / $148.19 / $174.30	Professional	TC	$126.00	$148.19	$174.30