Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.48 / $134.37 / $211.93	Facility	26	$69.48	$134.37	$211.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $386.69 / $470.84 / $1,142.43	Professional		$386.69	$470.84	$1,142.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.20 / $68.29 / $250.00	Professional	26	$53.20	$68.29	$250.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $332.36 / $369.41 / $718.15	Professional	TC	$332.36	$369.41	$718.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $769.95 / $955.00 / $1,185.43	Professional		$769.95	$955.00	$1,185.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.50 / $135.41 / $182.00	Professional	26	$110.50	$135.41	$182.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $593.00 / $823.85 / $1,003.33	Professional	TC	$593.00	$823.85	$1,003.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $378.29 / $606.49 / $1,681.91	Professional		$378.29	$606.49	$1,681.91
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $84.39 / $251.97	Professional	26	$52.48	$84.39	$251.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $325.81 / $556.23 / $1,443.12	Professional	TC	$325.81	$556.23	$1,443.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $514.79 / $934.37 / $3,905.69	Professional		$514.79	$934.37	$3,905.69
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $79.08 / $138.40 / $617.51	Professional	26	$79.08	$138.40	$617.51
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $409.00 / $784.18 / $3,576.06	Professional	TC	$409.00	$784.18	$3,576.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $548.37 / $872.01 / $1,120.19	Professional		$548.37	$872.01	$1,120.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.11 / $439.25 / $794.33	Professional		$58.11	$439.25	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $452.98 / $763.24 / $1,046.90	Professional		$452.98	$763.24	$1,046.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.97 / $110.01 / $158.16	Professional	26	$63.97	$110.01	$158.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $375.75 / $722.12 / $888.73	Professional	TC	$375.75	$722.12	$888.73
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $693.70 / $878.10 / $1,033.09	Professional		$693.70	$878.10	$1,033.09
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $88.56 / $112.10 / $131.90	Professional	26	$88.56	$112.10	$131.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $605.14 / $766.00 / $901.20	Professional	TC	$605.14	$766.00	$901.20