Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.34 / $87.27 / $119.53	Professional		$79.34	$87.27	$119.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.21 / $46.18 / $61.63	Professional	26	$36.21	$46.18	$61.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.39 / $41.64 / $59.08	Professional	TC	$31.39	$41.64	$59.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.00 / $192.62 / $230.59	Professional		$111.00	$192.62	$230.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.00 / $102.27 / $126.29	Professional	26	$77.00	$102.27	$126.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.41 / $91.42 / $114.28	Professional	TC	$42.41	$91.42	$114.28
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $77.09 / $108.16 / $205.37	Professional		$77.09	$108.16	$205.37
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.49 / $63.65 / $121.14	Professional	26	$40.49	$63.65	$121.14
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.01 / $49.67 / $93.10	Professional	TC	$36.01	$49.67	$93.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $94.00 / $192.62 / $567.30	Professional		$94.00	$192.62	$567.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $56.64 / $104.01 / $318.67	Professional	26	$56.64	$104.01	$318.67
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.25 / $84.91 / $318.67	Professional	TC	$38.25	$84.91	$318.67
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.00 / $172.98 / $230.59	Professional		$102.00	$172.98	$230.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.30 / $78.43 / $154.91	Professional		$42.30	$78.43	$154.91
United Facility/Professional Professional Modifier Low / Median / High Price $90.06 / $152.28 / $220.23	Professional		$90.06	$152.28	$220.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.43 / $90.80 / $121.64	Professional	26	$51.43	$90.80	$121.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.86 / $77.12 / $99.82	Professional	TC	$40.86	$77.12	$99.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $136.51 / $172.80 / $203.30	Professional		$136.51	$172.80	$203.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $68.48 / $86.70 / $102.00	Professional	26	$68.48	$86.70	$102.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $68.02 / $86.10 / $101.30	Professional	TC	$68.02	$86.10	$101.30