Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.94 / $148.08 / $239.28	Facility	26	$77.94	$148.08	$239.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.26 / $157.74 / $418.00	Professional		$91.26	$157.74	$418.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.24 / $83.56 / $295.00	Professional	26	$52.24	$83.56	$295.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.10 / $40.72 / $181.22	Professional	TC	$28.10	$40.72	$181.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.84 / $201.69 / $260.62	Professional		$146.84	$201.69	$260.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.31 / $127.88 / $161.84	Professional	26	$82.31	$127.88	$161.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.21 / $88.63 / $114.22	Professional	TC	$48.21	$88.63	$114.22
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $86.62 / $123.23 / $294.06	Professional		$86.62	$123.23	$294.06
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.15 / $68.70 / $156.99	Professional	26	$51.15	$68.70	$156.99
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.47 / $48.17 / $76.90	Professional	TC	$35.47	$48.17	$76.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $129.41 / $248.27 / $248.27	Facility	26	$129.41	$248.27	$248.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.58 / $183.51 / $746.58	Professional		$100.58	$183.51	$746.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $65.65 / $117.50 / $352.29	Professional	26	$65.65	$117.50	$352.29
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.57 / $50.72 / $288.04	Professional	TC	$31.57	$50.72	$288.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $122.60 / $184.79 / $238.60	Professional		$122.60	$184.79	$238.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.54 / $90.27 / $172.52	Professional		$42.54	$90.27	$172.52
United Facility/Professional Professional Modifier Low / Median / High Price $96.71 / $143.85 / $234.20	Professional		$96.71	$143.85	$234.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.06 / $91.73 / $154.22	Professional	26	$63.06	$91.73	$154.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.57 / $48.94 / $82.28	Professional	TC	$31.57	$48.94	$82.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $152.31 / $192.80 / $226.90	Professional		$152.31	$192.80	$226.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $86.43 / $109.40 / $128.69	Professional	26	$86.43	$109.40	$128.69
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $65.89 / $83.40 / $98.10	Professional	TC	$65.89	$83.40	$98.10