Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.43 / $211.22 / $211.22	Facility	26	$73.43	$211.22	$211.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.13 / $188.40 / $748.00	Professional		$138.13	$188.40	$748.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.87 / $91.69 / $374.00	Professional	26	$73.87	$91.69	$374.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.53 / $78.68 / $121.59	Professional	TC	$60.53	$78.68	$121.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.00 / $359.65 / $405.65	Professional		$199.00	$359.65	$405.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $139.00 / $185.03 / $212.58	Professional	26	$139.00	$185.03	$212.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.09 / $160.52 / $200.65	Professional	TC	$72.09	$160.52	$200.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $137.27 / $200.63 / $1,062.67	Professional		$137.27	$200.63	$1,062.67
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $73.43 / $119.34 / $518.69	Professional	26	$73.43	$119.34	$518.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.26 / $86.49 / $543.98	Professional	TC	$54.26	$86.49	$543.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $174.00 / $363.51 / $1,053.48	Professional		$174.00	$363.51	$1,053.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $101.74 / $188.76 / $509.36	Professional	26	$101.74	$188.76	$509.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $68.98 / $178.73 / $544.05	Professional	TC	$68.98	$178.73	$544.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $199.00 / $334.00 / $398.09	Professional		$199.00	$334.00	$398.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $74.78 / $142.01 / $277.95	Professional		$74.78	$142.01	$277.95
United Facility/Professional Professional Modifier Low / Median / High Price $165.78 / $338.63 / $431.42	Professional		$165.78	$338.63	$431.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.17 / $161.63 / $220.37	Professional	26	$93.17	$161.63	$220.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.88 / $131.18 / $216.99	Professional	TC	$83.88	$131.18	$216.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $243.56 / $308.30 / $362.70	Professional		$243.56	$308.30	$362.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $124.90 / $158.10 / $186.00	Professional	26	$124.90	$158.10	$186.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $118.58 / $150.10 / $176.60	Professional	TC	$118.58	$150.10	$176.60