Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.45 / $103.57 / $150.36	Professional		$87.45	$103.57	$150.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.59 / $74.40 / $108.11	Professional	26	$67.59	$74.40	$108.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.87 / $29.76 / $42.25	Professional	TC	$19.87	$29.76	$42.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.62 / $189.13 / $275.67	Professional		$86.62	$189.13	$275.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.00 / $144.81 / $198.90	Professional	26	$62.00	$144.81	$198.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.87 / $47.23 / $73.69	Professional	TC	$20.87	$47.23	$73.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $77.61 / $106.64 / $308.20	Professional		$77.61	$106.64	$308.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.77 / $74.76 / $107.31	Professional	26	$56.77	$74.76	$107.31
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.44 / $26.88 / $38.72	Professional	TC	$20.44	$26.88	$38.72
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $177.91 / $177.91 / $343.65	Facility	26	$177.91	$177.91	$343.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $99.06 / $151.47 / $317.75	Professional		$99.06	$151.47	$317.75
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $74.23 / $106.27 / $209.42	Professional	26	$74.23	$106.27	$209.42
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.99 / $32.97 / $67.95	Professional	TC	$21.99	$32.97	$67.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $140.12 / $213.64 / $287.04	Professional		$140.12	$213.64	$287.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $29.63 / $98.06 / $187.34	Professional		$29.63	$98.06	$187.34
United Facility/Professional Professional Modifier Low / Median / High Price $98.33 / $133.15 / $237.02	Professional		$98.33	$133.15	$237.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.27 / $106.27 / $178.79	Professional	26	$70.27	$106.27	$178.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.90 / $34.49 / $57.18	Professional	TC	$22.90	$34.49	$57.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $140.78 / $178.20 / $185.30	Professional		$140.78	$178.20	$185.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $101.75 / $128.80 / $133.90	Professional	26	$101.75	$128.80	$133.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $39.03 / $49.40 / $51.30	Professional	TC	$39.03	$49.40	$51.30