Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $240.90 / $773.81 / $1,229.52	Facility		$240.90	$773.81	$1,229.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.53 / $86.50 / $139.78	Facility	26	$45.53	$86.50	$139.78
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $213.69 / $673.86 / $965.12	Facility	TC	$213.69	$673.86	$965.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.71 / $243.81 / $871.00	Professional		$176.71	$243.81	$871.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.60 / $41.52 / $154.58	Professional	26	$30.60	$41.52	$154.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $143.61 / $173.35 / $401.78	Professional	TC	$143.61	$173.35	$401.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.98 / $448.68 / $760.94	Professional		$204.98	$448.68	$760.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.61 / $80.22 / $124.45	Professional	26	$35.61	$80.22	$124.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.03 / $368.49 / $632.98	Professional	TC	$169.03	$368.49	$632.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $159.75 / $249.51 / $559.78	Professional		$159.75	$249.51	$559.78
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.08 / $49.52 / $157.86	Professional	26	$30.08	$49.52	$157.86
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $129.68 / $201.21 / $403.68	Professional	TC	$129.68	$201.21	$403.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $253.43 / $434.99 / $726.49	Facility		$253.43	$434.99	$726.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $212.00 / $212.00 / $212.00	Facility	26	$212.00	$212.00	$212.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $677.45 / $691.80 / $691.80	Facility	TC	$677.45	$691.80	$691.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $224.12 / $408.86 / $1,578.90	Professional		$224.12	$408.86	$1,578.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $37.64 / $70.09 / $889.65	Professional	26	$37.64	$70.09	$889.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $170.13 / $313.99 / $1,388.59	Professional	TC	$170.13	$313.99	$1,388.59
Midlands Facility/Professional Facility Modifier Low / Median / High Price $347.19 / $434.99 / $493.23	Facility		$347.19	$434.99	$493.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $286.82 / $407.80 / $493.23	Professional		$286.82	$407.80	$493.23
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $834.99 / $3,947.09 / $8,035.17	Facility		$834.99	$3,947.09	$8,035.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.51 / $168.31 / $323.86	Professional		$33.51	$168.31	$323.86
United Facility/Professional Professional Modifier Low / Median / High Price $199.45 / $330.87 / $496.45	Professional		$199.45	$330.87	$496.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.36 / $53.41 / $90.79	Professional	26	$35.36	$53.41	$90.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.47 / $287.74 / $402.40	Professional	TC	$163.47	$287.74	$402.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $269.23 / $340.80 / $400.90	Professional		$269.23	$340.80	$400.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $59.20 / $69.59	Professional	26	$46.77	$59.20	$69.59
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $222.46 / $281.60 / $331.30	Professional	TC	$222.46	$281.60	$331.30