Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.79 / $60.09 / $135.49	Facility	26	$44.79	$60.09	$135.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.44 / $169.73 / $780.00	Professional		$129.44	$169.73	$780.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.63 / $40.50 / $217.00	Professional	26	$31.63	$40.50	$217.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.82 / $115.91 / $556.00	Professional	TC	$97.82	$115.91	$556.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $143.52 / $147.83 / $152.13	Facility	26	$143.52	$147.83	$152.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.00 / $373.29 / $466.62	Professional		$237.00	$373.29	$466.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.20 / $94.05 / $115.29	Professional	26	$72.20	$94.05	$115.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $152.41 / $286.12 / $357.65	Professional	TC	$152.41	$286.12	$357.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.62 / $234.29 / $284.62	Professional		$151.62	$234.29	$284.62
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.85 / $68.16 / $115.01	Professional	26	$42.85	$68.16	$115.01
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $94.05 / $147.13 / $205.17	Professional	TC	$94.05	$147.13	$205.17
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $147.83 / $239.31 / $239.31	Facility	26	$147.83	$239.31	$239.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $139.13 / $191.65 / $503.68	Professional		$139.13	$191.65	$503.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $44.18 / $54.19 / $326.98	Professional	26	$44.18	$54.19	$326.98
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $77.50 / $125.02 / $871.18	Professional	TC	$77.50	$125.02	$871.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $147.83 / $152.13 / $236.52	Facility	26	$147.83	$152.13	$236.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $195.63 / $303.93 / $461.18	Professional		$195.63	$303.93	$461.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $156.94 / $288.63	Professional		$41.03	$156.94	$288.63
United Facility/Professional Professional Modifier Low / Median / High Price $130.46 / $169.20 / $360.88	Professional		$130.46	$169.20	$360.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.96 / $44.18 / $103.43	Professional	26	$38.96	$44.18	$103.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.65 / $125.02 / $222.99	Professional	TC	$82.65	$125.02	$222.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $296.20 / $348.40 / $409.80	Professional		$296.20	$348.40	$409.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $70.40 / $82.80 / $97.30	Professional	26	$70.40	$82.80	$97.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $225.80 / $265.70 / $312.39	Professional	TC	$225.80	$265.70	$312.39