Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.16 / $144.69 / $233.81	Facility	26	$76.16	$144.69	$233.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.93 / $313.11 / $1,182.00	Professional		$246.93	$313.11	$1,182.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.98 / $93.06 / $372.50	Professional	26	$51.98	$93.06	$372.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.35 / $204.52 / $455.52	Professional	TC	$162.35	$204.52	$455.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $320.63 / $635.41 / $1,072.67	Professional		$320.63	$635.41	$1,072.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.55 / $134.29 / $222.12	Professional	26	$65.55	$134.29	$222.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $228.97 / $501.12 / $858.95	Professional	TC	$228.97	$501.12	$858.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $226.31 / $383.03 / $929.08	Professional		$226.31	$383.03	$929.08
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.66 / $94.68 / $275.33	Professional	26	$50.66	$94.68	$275.33
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $175.64 / $267.95 / $610.74	Professional	TC	$175.64	$267.95	$610.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $377.88 / $377.88 / $377.88	Facility	26	$377.88	$377.88	$377.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $330.37 / $581.99 / $2,362.07	Professional		$330.37	$581.99	$2,362.07
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $64.04 / $132.52 / $507.12	Professional	26	$64.04	$132.52	$507.12
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $232.78 / $439.11 / $1,854.93	Professional	TC	$232.78	$439.11	$1,854.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $388.44 / $528.86 / $748.60	Professional		$388.44	$528.86	$748.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $55.58 / $238.12 / $458.56	Professional		$55.58	$238.12	$458.56
United Facility/Professional Professional Modifier Low / Median / High Price $283.91 / $471.29 / $774.30	Professional		$283.91	$471.29	$774.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.25 / $115.41 / $167.04	Professional	26	$61.25	$115.41	$167.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.75 / $367.64 / $575.54	Professional	TC	$223.75	$367.64	$575.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $380.23 / $481.30 / $566.20	Professional		$380.23	$481.30	$566.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $78.84 / $99.80 / $117.50	Professional	26	$78.84	$99.80	$117.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $301.39 / $381.50 / $448.80	Professional	TC	$301.39	$381.50	$448.80