Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $409.90 / $409.90 / $409.90	Facility	26	$409.90	$409.90	$409.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $230.57 / $317.98 / $1,069.00	Professional		$230.57	$317.98	$1,069.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $142.35 / $180.22 / $409.90	Professional	26	$142.35	$180.22	$409.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.57 / $114.98 / $235.29	Professional	TC	$85.57	$114.98	$235.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $428.35 / $567.32 / $658.23	Professional		$428.35	$567.32	$658.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $262.85 / $338.04 / $398.68	Professional	26	$262.85	$338.04	$398.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $159.93 / $213.43 / $267.27	Professional	TC	$159.93	$213.43	$267.27
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $218.06 / $337.49 / $813.92	Professional		$218.06	$337.49	$813.92
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $143.15 / $220.20 / $490.23	Professional	26	$143.15	$220.20	$490.23
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $74.91 / $117.27 / $209.65	Professional	TC	$74.91	$117.27	$209.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $335.19 / $567.32 / $1,600.14	Professional		$335.19	$567.32	$1,600.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $200.65 / $353.48 / $982.86	Professional	26	$200.65	$353.48	$982.86
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $124.00 / $214.00 / $617.27	Professional	TC	$124.00	$214.00	$617.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $386.71 / $519.29 / $664.06	Professional		$386.71	$519.29	$664.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.82 / $227.74 / $436.59	Professional		$89.82	$227.74	$436.59
United Facility/Professional Professional Modifier Low / Median / High Price $288.66 / $501.02 / $682.75	Professional		$288.66	$501.02	$682.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $180.27 / $338.82 / $470.28	Professional	26	$180.27	$338.82	$470.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.67 / $186.82 / $256.36	Professional	TC	$103.67	$186.82	$256.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $382.68 / $484.40 / $569.90	Professional		$382.68	$484.40	$569.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $243.56 / $308.30 / $362.70	Professional	26	$243.56	$308.30	$362.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $139.19 / $176.20 / $207.20	Professional	TC	$139.19	$176.20	$207.20