Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.02 / $141.52 / $221.20	Facility	26	$63.02	$141.52	$221.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.64 / $258.27 / $363.92	Professional		$206.64	$258.27	$363.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.27 / $48.90 / $83.19	Professional	26	$43.27	$48.90	$83.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.49 / $215.11 / $300.89	Professional	TC	$162.49	$215.11	$300.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.95 / $544.36 / $1,045.50	Professional		$275.95	$544.36	$1,045.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.44 / $110.12 / $175.74	Professional	26	$48.44	$110.12	$175.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $227.51 / $452.24 / $869.76	Professional	TC	$227.51	$452.24	$869.76
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $221.53 / $376.71 / $746.08	Professional		$221.53	$376.71	$746.08
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.64 / $65.08 / $131.55	Professional	26	$41.64	$65.08	$131.55
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $179.89 / $305.54 / $571.71	Professional	TC	$179.89	$305.54	$571.71
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $202.83 / $202.83 / $202.83	Facility	26	$202.83	$202.83	$202.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $314.60 / $523.40 / $1,904.10	Professional		$314.60	$523.40	$1,904.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.16 / $95.63 / $588.72	Professional	26	$51.16	$95.63	$588.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $238.64 / $435.77 / $1,640.58	Professional	TC	$238.64	$435.77	$1,640.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $334.08 / $510.84 / $715.79	Professional		$334.08	$510.84	$715.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.56 / $250.91 / $453.27	Professional		$47.56	$250.91	$453.27
United Facility/Professional Professional Modifier Low / Median / High Price $279.08 / $406.03 / $725.61	Professional		$279.08	$406.03	$725.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.72 / $75.77 / $125.66	Professional	26	$48.72	$75.77	$125.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.17 / $344.79 / $622.53	Professional	TC	$229.17	$344.79	$622.53
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $373.91 / $473.30 / $556.79	Professional		$373.91	$473.30	$556.79
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $65.25 / $82.60 / $97.20	Professional	26	$65.25	$82.60	$97.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $308.64 / $390.70 / $459.60	Professional	TC	$308.64	$390.70	$459.60