Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.06 / $179.05 / $284.52	Facility	26	$81.06	$179.05	$284.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.71 / $169.26 / $237.71	Professional		$151.71	$169.26	$237.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $60.25 / $81.06	Professional	26	$53.70	$60.25	$81.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.29 / $109.01 / $161.05	Professional	TC	$96.29	$109.01	$161.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.19 / $621.13 / $868.47	Professional		$291.19	$621.13	$868.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.86 / $142.38 / $214.24	Professional	26	$61.86	$142.38	$214.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.70 / $501.79 / $679.18	Professional	TC	$216.70	$501.79	$679.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $253.47 / $395.03 / $573.51	Professional		$253.47	$395.03	$573.51
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.71 / $82.61 / $105.09	Professional	26	$53.71	$82.61	$105.09
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $199.76 / $309.83 / $469.60	Professional	TC	$199.76	$309.83	$469.60
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $261.89 / $261.89 / $261.89	Facility	26	$261.89	$261.89	$261.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $317.95 / $476.93 / $1,731.57	Professional		$317.95	$476.93	$1,731.57
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $64.28 / $120.43 / $367.94	Professional	26	$64.28	$120.43	$367.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $255.07 / $484.98 / $1,410.54	Professional	TC	$255.07	$484.98	$1,410.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $251.09 / $356.65 / $581.66	Professional		$251.09	$356.65	$581.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.02 / $285.27 / $522.10	Professional		$61.02	$285.27	$522.10
United Facility/Professional Professional Modifier Low / Median / High Price $317.95 / $540.00 / $789.67	Professional		$317.95	$540.00	$789.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.71 / $94.15 / $158.96	Professional	26	$61.71	$94.15	$158.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $255.07 / $384.36 / $630.71	Professional	TC	$255.07	$384.36	$630.71
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $427.00 / $540.50 / $635.79	Professional		$427.00	$540.50	$635.79
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $84.21 / $106.60 / $125.40	Professional	26	$84.21	$106.60	$125.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $342.70 / $433.80 / $510.40	Professional	TC	$342.70	$433.80	$510.40