Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $485.94 / $485.94 / $485.94	Facility	26	$485.94	$485.94	$485.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $270.29 / $392.57 / $1,381.00	Professional		$270.29	$392.57	$1,381.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $168.93 / $218.27 / $443.72	Professional	26	$168.93	$218.27	$443.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.55 / $128.54 / $259.93	Professional	TC	$94.55	$128.54	$259.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $485.47 / $657.56 / $757.49	Professional		$485.47	$657.56	$757.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $310.05 / $400.93 / $472.83	Professional	26	$310.05	$400.93	$472.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $176.62 / $236.49 / $296.17	Professional	TC	$176.62	$236.49	$296.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $255.49 / $395.19 / $1,207.36	Professional		$255.49	$395.19	$1,207.36
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $169.79 / $261.11 / $603.54	Professional	26	$169.79	$261.11	$603.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.69 / $134.09 / $771.83	Professional	TC	$85.69	$134.09	$771.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $387.96 / $657.56 / $1,850.58	Professional		$387.96	$657.56	$1,850.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $238.23 / $419.66 / $1,166.03	Professional	26	$238.23	$419.66	$1,166.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $138.38 / $236.16 / $684.55	Professional	TC	$138.38	$236.16	$684.55
Midlands Facility/Professional Professional Modifier Low / Median / High Price $444.44 / $601.73 / $767.80	Professional		$444.44	$601.73	$767.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $103.98 / $266.60 / $512.96	Professional		$103.98	$266.60	$512.96
United Facility/Professional Professional Modifier Low / Median / High Price $334.47 / $632.73 / $791.09	Professional		$334.47	$632.73	$791.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $214.03 / $323.16 / $506.22	Professional	26	$214.03	$323.16	$506.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.44 / $209.04 / $284.87	Professional	TC	$120.44	$209.04	$284.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $448.09 / $567.20 / $667.30	Professional		$448.09	$567.20	$667.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $288.89 / $365.70 / $430.20	Professional	26	$288.89	$365.70	$430.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $159.19 / $201.50 / $237.10	Professional	TC	$159.19	$201.50	$237.10