Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $257.04 / $389.05	Professional		$162.18	$257.04	$389.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $39.81 / $112.20	Professional	26	$30.90	$39.81	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $218.78 / $338.84	Professional	TC	$128.82	$218.78	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $478.63 / $758.58	Professional		$158.49	$478.63	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $72.44 / $112.20	Professional	26	$33.88	$72.44	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $407.38 / $645.65	Professional	TC	$134.90	$407.38	$645.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $426.58 / $776.25	Professional		$208.93	$426.58	$776.25
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $57.54 / $154.88	Professional	26	$32.36	$57.54	$154.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $309.03 / $616.60	Professional	TC	$173.78	$309.03	$616.60
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $181.97 / $181.97	Facility	26	$181.97	$181.97	$181.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $512.86 / $2,089.30	Professional		$194.98	$512.86	$2,089.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $69.18 / $269.15	Professional	26	$44.67	$69.18	$269.15
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $309.03 / $1,819.70	Professional	TC	$147.91	$309.03	$1,819.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $478.63 / $776.25	Professional		$316.23	$478.63	$776.25
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $81.28 / $177.83	Professional	26	$47.86	$81.28	$177.83
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $407.38 / $676.08	Professional	TC	$269.15	$407.38	$676.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $602.56 / $602.56	Professional		$407.38	$602.56	$602.56
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $89.13 / $91.20	Professional	26	$89.13	$89.13	$91.20
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $512.86 / $512.86	Professional	TC	$323.59	$512.86	$512.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $245.47 / $512.86	Professional		$41.69	$245.47	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $346.74 / $776.25	Professional		$316.23	$346.74	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $45.71 / $125.89	Professional	26	$44.67	$45.71	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $295.12 / $645.65	Professional	TC	$275.42	$295.12	$645.65
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $549.54 / $645.65	Professional		$467.74	$549.54	$645.65
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $81.28 / $95.50	Professional	26	$69.18	$81.28	$95.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $467.74 / $549.54	Professional	TC	$398.11	$467.74	$549.54