Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $533.24 / $753.23 / $994.69	Facility		$533.24	$753.23	$994.69
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.88 / $97.54 / $157.61	Facility	26	$71.88	$97.54	$157.61
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $315.00 / $516.47 / $944.18	Facility	TC	$315.00	$516.47	$944.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.31 / $269.25 / $928.00	Professional		$189.31	$269.25	$928.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.65 / $38.92 / $172.00	Professional	26	$29.65	$38.92	$172.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.35 / $198.00 / $362.69	Professional	TC	$162.35	$198.00	$362.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $249.87 / $554.14 / $974.66	Professional		$249.87	$554.14	$974.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.59 / $79.20 / $116.42	Professional	26	$33.59	$79.20	$116.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.28 / $465.53 / $829.00	Professional	TC	$216.28	$465.53	$829.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $204.14 / $318.98 / $717.81	Professional		$204.14	$318.98	$717.81
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.46 / $51.21 / $142.04	Professional	26	$34.46	$51.21	$142.04
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.69 / $265.52 / $491.58	Professional	TC	$169.69	$265.52	$491.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $323.18 / $497.70 / $744.71	Facility		$323.18	$497.70	$744.71
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $205.00 / $205.00 / $205.00	Facility	26	$205.00	$205.00	$205.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $906.68 / $906.68 / $906.68	Facility	TC	$906.68	$906.68	$906.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $282.97 / $492.49 / $1,952.19	Professional		$282.97	$492.49	$1,952.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.06 / $78.59 / $399.57	Professional	26	$40.06	$78.59	$399.57
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $227.51 / $415.46 / $1,791.16	Professional	TC	$227.51	$415.46	$1,791.16
Midlands Facility/Professional Facility Modifier Low / Median / High Price $369.00 / $478.59 / $620.91	Facility		$369.00	$478.59	$620.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $316.76 / $464.49 / $632.01	Professional		$316.76	$464.49	$632.01
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $358.34 / $1,630.02 / $3,318.26	Facility		$358.34	$1,630.02	$3,318.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.99 / $224.59 / $418.92	Professional		$39.99	$224.59	$418.92
United Facility/Professional Professional Modifier Low / Median / High Price $258.76 / $429.99 / $674.42	Professional		$258.76	$429.99	$674.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.06 / $60.76 / $103.28	Professional	26	$38.06	$60.76	$103.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.70 / $343.53 / $538.12	Professional	TC	$218.70	$343.53	$538.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $344.68 / $436.30 / $513.29	Professional		$344.68	$436.30	$513.29
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $53.56 / $67.80 / $79.80	Professional	26	$53.56	$67.80	$79.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $291.12 / $368.50 / $433.60	Professional	TC	$291.12	$368.50	$433.60