Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.96 / $96.17 / $258.08	Professional		$81.96	$96.17	$258.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.62 / $28.25 / $54.07	Professional	26	$24.62	$28.25	$54.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.34 / $67.92 / $204.02	Professional	TC	$57.34	$67.92	$204.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $222.38 / $566.69	Professional		$96.53	$222.38	$566.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.35 / $65.09 / $129.57	Professional	26	$38.35	$65.09	$129.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.30 / $157.40 / $437.12	Professional	TC	$88.30	$157.40	$437.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $108.08 / $173.15 / $492.58	Professional		$108.08	$173.15	$492.58
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.20 / $53.08 / $211.57	Professional	26	$33.20	$53.08	$211.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $74.88 / $120.07 / $311.45	Professional	TC	$74.88	$120.07	$311.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $256.47 / $256.47 / $256.47	Facility	26	$256.47	$256.47	$256.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $106.52 / $222.38 / $1,210.67	Professional		$106.52	$222.38	$1,210.67
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $34.68 / $57.71 / $360.79	Professional	26	$34.68	$57.71	$360.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $71.84 / $143.68 / $914.18	Professional	TC	$71.84	$143.68	$914.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $160.87 / $160.87 / $160.87	Facility	26	$160.87	$160.87	$160.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $126.66 / $205.56 / $415.65	Professional		$126.66	$205.56	$415.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.70 / $98.25 / $182.06	Professional		$31.70	$98.25	$182.06
United Facility/Professional Professional Modifier Low / Median / High Price $106.52 / $109.72 / $285.20	Professional		$106.52	$109.72	$285.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.68 / $35.72 / $84.11	Professional	26	$34.68	$35.72	$84.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.84 / $74.00 / $191.69	Professional	TC	$71.84	$74.00	$191.69
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $185.50 / $218.30 / $256.70	Professional		$185.50	$218.30	$256.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $54.50 / $64.09 / $75.40	Professional	26	$54.50	$64.09	$75.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $131.10 / $154.19 / $181.30	Professional	TC	$131.10	$154.19	$181.30