Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.13 / $99.65 / $161.02	Facility	26	$42.13	$99.65	$161.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.24 / $246.56 / $918.85	Professional		$177.24	$246.56	$918.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.53 / $39.31 / $113.00	Professional	26	$31.53	$39.31	$113.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.44 / $171.50 / $389.04	Professional	TC	$141.44	$171.50	$389.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.54 / $456.22 / $773.19	Professional		$208.54	$456.22	$773.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.78 / $83.04 / $116.25	Professional	26	$34.78	$83.04	$116.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $176.13 / $363.69 / $624.80	Professional	TC	$176.13	$363.69	$624.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $162.72 / $254.15 / $574.78	Professional		$162.72	$254.15	$574.78
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.02 / $52.87 / $105.82	Professional	26	$35.02	$52.87	$105.82
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $127.69 / $199.82 / $467.46	Professional	TC	$127.69	$199.82	$467.46
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $210.00 / $210.00 / $210.00	Facility	26	$210.00	$210.00	$210.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $229.42 / $395.53 / $1,582.03	Professional		$229.42	$395.53	$1,582.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.78 / $75.42 / $422.69	Professional	26	$40.78	$75.42	$422.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $169.37 / $318.77 / $1,414.75	Professional	TC	$169.37	$318.77	$1,414.75
Midlands Facility/Professional Professional Modifier Low / Median / High Price $256.00 / $380.32 / $497.73	Professional		$256.00	$380.32	$497.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.64 / $177.04 / $333.95	Professional		$39.64	$177.04	$333.95
United Facility/Professional Professional Modifier Low / Median / High Price $204.50 / $309.85 / $505.67	Professional		$204.50	$309.85	$505.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.75 / $61.81 / $103.92	Professional	26	$39.75	$61.81	$103.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.77 / $270.24 / $400.60	Professional	TC	$162.77	$270.24	$400.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $273.58 / $346.30 / $407.40	Professional		$273.58	$346.30	$407.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $54.51 / $69.00 / $81.20	Professional	26	$54.51	$69.00	$81.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $219.07 / $277.30 / $326.30	Professional	TC	$219.07	$277.30	$326.30