Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.02 / $82.16 / $152.34	Facility	26	$34.02	$82.16	$152.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.04 / $115.22 / $631.00	Professional		$98.04	$115.22	$631.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.95 / $28.77 / $96.69	Professional	26	$24.95	$28.77	$96.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.01 / $86.44 / $455.00	Professional	TC	$73.01	$86.44	$455.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.21 / $88.80 / $91.38	Facility	26	$86.21	$88.80	$91.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.89 / $276.27 / $345.35	Professional		$179.89	$276.27	$345.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.61 / $68.89 / $86.12	Professional	26	$54.61	$68.89	$86.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $140.88 / $207.39 / $259.23	Professional	TC	$140.88	$207.39	$259.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $127.57 / $191.35 / $286.70	Professional		$127.57	$191.35	$286.70
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.84 / $50.75 / $130.49	Professional	26	$33.84	$50.75	$130.49
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $84.49 / $140.58 / $156.69	Professional	TC	$84.49	$140.58	$156.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $88.80 / $148.36 / $148.36	Facility	26	$88.80	$148.36	$148.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $88.98 / $140.38 / $377.04	Professional		$88.98	$140.38	$377.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.17 / $34.90 / $110.94	Professional	26	$26.17	$34.90	$110.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $62.44 / $94.42 / $286.14	Professional	TC	$62.44	$94.42	$286.14
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $88.80 / $91.38 / $186.78	Facility	26	$88.80	$91.38	$186.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $149.81 / $227.89 / $349.49	Professional		$149.81	$227.89	$349.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.38 / $117.33 / $214.17	Professional		$32.38	$117.33	$214.17
United Facility/Professional Professional Modifier Low / Median / High Price $91.91 / $129.33 / $229.53	Professional		$91.91	$129.33	$229.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.36 / $34.90 / $76.31	Professional	26	$26.36	$34.90	$76.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.62 / $94.42 / $194.15	Professional	TC	$62.62	$94.42	$194.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $219.60 / $258.30 / $303.80	Professional		$219.60	$258.30	$303.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $55.60 / $65.40 / $76.90	Professional	26	$55.60	$65.40	$76.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $164.00 / $192.90 / $226.90	Professional	TC	$164.00	$192.90	$226.90