Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $316.26 / $808.35 / $2,395.92	Facility		$316.26	$808.35	$2,395.92
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.75 / $181.27 / $327.57	Facility	26	$70.75	$181.27	$327.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.86 / $266.64 / $884.00	Professional		$183.86	$266.64	$884.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.17 / $76.53 / $275.00	Professional	26	$63.17	$76.53	$275.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.48 / $175.12 / $666.00	Professional	TC	$124.48	$175.12	$666.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $292.35 / $477.17 / $797.69	Professional		$292.35	$477.17	$797.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.49 / $159.34 / $253.64	Professional	26	$86.49	$159.34	$253.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $195.38 / $307.14 / $525.44	Professional	TC	$195.38	$307.14	$525.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $170.71 / $256.08 / $719.18	Professional		$170.71	$256.08	$719.18
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.16 / $91.60 / $241.32	Professional	26	$63.16	$91.60	$241.32
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $107.55 / $164.29 / $484.13	Professional	TC	$107.55	$164.29	$484.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $266.64 / $527.83 / $1,408.12	Facility		$266.64	$527.83	$1,408.12
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $305.79 / $305.79 / $305.79	Facility	26	$305.79	$305.79	$305.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $215.19 / $414.71 / $3,949.29	Professional		$215.19	$414.71	$3,949.29
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $116.13 / $433.24	Professional	26	$75.86	$116.13	$433.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $136.41 / $261.02 / $1,005.74	Professional	TC	$136.41	$261.02	$1,005.74
Midlands Facility/Professional Facility Modifier Low / Median / High Price $369.19 / $452.51 / $543.11	Facility		$369.19	$452.51	$543.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $331.29 / $452.51 / $544.04	Professional		$331.29	$452.51	$544.04
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $525.29 / $1,815.66 / $3,696.17	Facility		$525.29	$1,815.66	$3,696.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $67.37 / $178.36 / $343.86	Professional		$67.37	$178.36	$343.86
United Facility/Professional Professional Modifier Low / Median / High Price $211.49 / $339.30 / $555.59	Professional		$211.49	$339.30	$555.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.06 / $107.31 / $205.19	Professional	26	$75.06	$107.31	$205.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $135.71 / $209.34 / $350.40	Professional	TC	$135.71	$209.34	$350.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $306.27 / $387.70 / $456.10	Professional		$306.27	$387.70	$456.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $106.49 / $134.80 / $158.60	Professional	26	$106.49	$134.80	$158.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $199.79 / $252.90 / $297.50	Professional	TC	$199.79	$252.90	$297.50