Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.46 / $147.49 / $147.49	Facility	26	$51.46	$147.49	$147.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.81 / $424.06 / $977.47	Professional		$302.81	$424.06	$977.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.54 / $66.43 / $259.00	Professional	26	$51.54	$66.43	$259.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.27 / $316.08 / $829.13	Professional	TC	$251.27	$316.08	$829.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $376.85 / $824.92 / $1,031.15	Professional		$376.85	$824.92	$1,031.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.00 / $124.74 / $145.32	Professional	26	$97.00	$124.74	$145.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $309.14 / $710.46 / $888.08	Professional	TC	$309.14	$710.46	$888.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $308.86 / $451.20 / $624.50	Professional		$308.86	$451.20	$624.50
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.43 / $81.00 / $176.96	Professional	26	$51.43	$81.00	$176.96
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $240.20 / $362.70 / $496.31	Professional	TC	$240.20	$362.70	$496.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $300.54 / $765.27 / $2,452.27	Professional		$300.54	$765.27	$2,452.27
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $69.89 / $130.74 / $354.09	Professional	26	$69.89	$130.74	$354.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $268.79 / $638.00 / $2,098.17	Professional	TC	$268.79	$638.00	$2,098.17
Midlands Facility/Professional Professional Modifier Low / Median / High Price $347.00 / $699.05 / $948.31	Professional		$347.00	$699.05	$948.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.56 / $379.61 / $689.96	Professional		$56.56	$379.61	$689.96
United Facility/Professional Professional Modifier Low / Median / High Price $368.15 / $631.25 / $912.93	Professional		$368.15	$631.25	$912.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.91 / $105.76 / $153.52	Professional	26	$64.91	$105.76	$153.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $311.23 / $480.38 / $769.60	Professional	TC	$311.23	$480.38	$769.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $612.49 / $775.30 / $912.20	Professional		$612.49	$775.30	$912.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $87.53 / $110.80 / $130.30	Professional	26	$87.53	$110.80	$130.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $525.03 / $664.60 / $781.90	Professional	TC	$525.03	$664.60	$781.90