Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.81 / $223.02 / $223.02	Facility	26	$77.81	$223.02	$223.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $322.56 / $457.11 / $2,212.91	Professional		$322.56	$457.11	$2,212.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.83 / $117.38 / $414.76	Professional	26	$77.83	$117.38	$414.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $261.80 / $358.03 / $863.60	Professional	TC	$261.80	$358.03	$863.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $474.00 / $942.86 / $1,178.58	Professional		$474.00	$942.86	$1,178.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $150.47 / $197.53 / $222.53	Professional	26	$150.47	$197.53	$222.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $350.25 / $769.09 / $961.36	Professional	TC	$350.25	$769.09	$961.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $383.61 / $517.66 / $765.49	Professional		$383.61	$517.66	$765.49
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.76 / $123.33 / $201.45	Professional	26	$77.76	$123.33	$201.45
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $285.35 / $414.21 / $594.71	Professional	TC	$285.35	$414.21	$594.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $419.40 / $869.13 / $2,747.80	Professional		$419.40	$869.13	$2,747.80
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $110.81 / $198.76 / $774.69	Professional	26	$110.81	$198.76	$774.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $280.91 / $683.04 / $2,208.88	Professional	TC	$280.91	$683.04	$2,208.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $473.76 / $829.54 / $1,067.23	Professional		$473.76	$829.54	$1,067.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $88.04 / $441.42 / $794.77	Professional		$88.04	$441.42	$794.77
United Facility/Professional Professional Modifier Low / Median / High Price $419.40 / $800.67 / $1,029.72	Professional		$419.40	$800.67	$1,029.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.42 / $180.35 / $245.37	Professional	26	$98.42	$180.35	$245.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $325.26 / $549.98 / $804.28	Professional	TC	$325.26	$549.98	$804.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $700.57 / $886.80 / $1,043.30	Professional		$700.57	$886.80	$1,043.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $132.33 / $167.50 / $197.00	Professional	26	$132.33	$167.50	$197.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $568.25 / $719.30 / $846.20	Professional	TC	$568.25	$719.30	$846.20