Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.00 / $206.22 / $206.22	Facility	26	$72.00	$206.22	$206.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.92 / $185.00 / $558.00	Professional		$125.92	$185.00	$558.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.04 / $101.62 / $479.97	Professional	26	$72.04	$101.62	$479.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.76 / $67.92 / $142.29	Professional	TC	$51.76	$67.92	$142.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.68 / $304.01 / $436.29	Professional		$235.68	$304.01	$436.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $132.88 / $173.87 / $252.59	Professional	26	$132.88	$173.87	$252.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $96.65 / $135.35 / $183.70	Professional	TC	$96.65	$135.35	$183.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $118.66 / $181.65 / $545.54	Professional		$118.66	$181.65	$545.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.84 / $110.21 / $256.32	Professional	26	$71.84	$110.21	$256.32
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.82 / $73.25 / $322.39	Professional	TC	$46.82	$73.25	$322.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $185.86 / $312.70 / $874.03	Professional		$185.86	$312.70	$874.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $102.15 / $180.81 / $497.06	Professional	26	$102.15	$180.81	$497.06
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $75.23 / $133.99 / $376.97	Professional	TC	$75.23	$133.99	$376.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $221.78 / $295.95 / $381.58	Professional		$221.78	$295.95	$381.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.21 / $123.54 / $238.44	Professional		$57.21	$123.54	$238.44
United Facility/Professional Professional Modifier Low / Median / High Price $159.47 / $288.91 / $377.21	Professional		$159.47	$288.91	$377.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.17 / $158.25 / $237.84	Professional	26	$91.17	$158.25	$237.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.31 / $132.46 / $161.57	Professional	TC	$68.31	$132.46	$161.57
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $209.27 / $264.89 / $311.60	Professional		$209.27	$264.89	$311.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $122.29 / $154.80 / $182.10	Professional	26	$122.29	$154.80	$182.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $86.98 / $110.10 / $129.50	Professional	TC	$86.98	$110.10	$129.50