Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.10 / $117.60 / $117.60	Facility	26	$41.10	$117.60	$117.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $292.89 / $376.50 / $488.45	Professional		$292.89	$376.50	$488.45
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $135.47 / $201.17 / $244.23	Professional	52	$135.47	$201.17	$244.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $252.77 / $323.49 / $426.55	Professional	TC	$252.77	$323.49	$426.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $544.78 / $793.51 / $991.89	Professional		$544.78	$793.51	$991.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $464.37 / $702.09 / $877.61	Professional	TC	$464.37	$702.09	$877.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $320.38 / $483.28 / $4,370.91	Professional		$320.38	$483.28	$4,370.91
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.20 / $61.54 / $701.72	Professional	26	$41.20	$61.54	$701.72
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $279.19 / $436.34 / $3,669.19	Professional	TC	$279.19	$436.34	$3,669.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $399.63 / $723.75 / $2,332.00	Professional		$399.63	$723.75	$2,332.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $321.23 / $629.86 / $2,048.28	Professional	TC	$321.23	$629.86	$2,048.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $498.15 / $677.84 / $961.99	Professional		$498.15	$677.84	$961.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $45.19 / $366.96 / $663.57	Professional		$45.19	$366.96	$663.57
United Facility/Professional Professional Modifier Low / Median / High Price $373.23 / $682.48 / $914.76	Professional		$373.23	$682.48	$914.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $317.04 / $557.54 / $751.40	Professional	TC	$317.04	$557.54	$751.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $588.79 / $745.30 / $876.80	Professional		$588.79	$745.30	$876.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $518.71 / $656.60 / $772.40	Professional	TC	$518.71	$656.60	$772.40