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 $338.67 / $420.11 / $1,995.00	Professional		$338.67	$420.11	$1,995.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.64 / $73.16 / $253.00	Professional	26	$51.64	$73.16	$253.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.79 / $361.50 / $985.45	Professional	TC	$281.79	$361.50	$985.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $423.38 / $961.71 / $1,202.13	Professional		$423.38	$961.71	$1,202.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.00 / $126.24 / $172.31	Professional	26	$97.00	$126.24	$172.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $337.38 / $847.25 / $1,059.06	Professional	TC	$337.38	$847.25	$1,059.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $329.99 / $506.25 / $675.08	Professional		$329.99	$506.25	$675.08
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.43 / $78.98 / $159.87	Professional	26	$51.43	$78.98	$159.87
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $258.13 / $406.30 / $591.59	Professional	TC	$258.13	$406.30	$591.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $324.00 / $857.67 / $2,879.21	Professional		$324.00	$857.67	$2,879.21
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $69.89 / $132.12 / $356.25	Professional	26	$69.89	$132.12	$356.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $328.18 / $732.52 / $2,522.94	Professional	TC	$328.18	$732.52	$2,522.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $352.46 / $805.86 / $1,133.72	Professional		$352.46	$805.86	$1,133.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.87 / $442.39 / $803.34	Professional		$56.87	$442.39	$803.34
United Facility/Professional Professional Modifier Low / Median / High Price $438.37 / $748.11 / $1,077.92	Professional		$438.37	$748.11	$1,077.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.27 / $113.29 / $154.38	Professional	26	$65.27	$113.29	$154.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $379.99 / $588.79 / $914.27	Professional	TC	$379.99	$588.79	$914.27
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $713.21 / $902.80 / $1,062.09	Professional		$713.21	$902.80	$1,062.09
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 $625.67 / $792.00 / $931.80	Professional	TC	$625.67	$792.00	$931.80