Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $242.28 / $347.32 / $655.13	Professional		$242.28	$347.32	$655.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.15 / $109.46 / $177.90	Professional	26	$92.15	$109.46	$177.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.33 / $233.83 / $477.22	Professional	TC	$148.33	$233.83	$477.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $384.11 / $613.45 / $766.82	Professional		$384.11	$613.45	$766.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $176.00 / $231.09 / $309.08	Professional	26	$176.00	$231.09	$309.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $222.00 / $407.57 / $528.84	Professional	TC	$222.00	$407.57	$528.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $255.09 / $352.69 / $575.66	Professional		$255.09	$352.69	$575.66
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $92.50 / $145.56 / $263.25	Professional	26	$92.50	$145.56	$263.25
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $141.66 / $228.51 / $353.78	Professional	TC	$141.66	$228.51	$353.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $277.77 / $596.61 / $2,013.87	Professional		$277.77	$596.61	$2,013.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $128.18 / $239.51 / $716.57	Professional	26	$128.18	$239.51	$716.57
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $161.26 / $351.03 / $1,590.04	Professional	TC	$161.26	$351.03	$1,590.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $349.62 / $577.72 / $726.60	Professional		$349.62	$577.72	$726.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $101.13 / $287.19 / $519.79	Professional		$101.13	$287.19	$519.79
United Facility/Professional Professional Modifier Low / Median / High Price $265.69 / $507.23 / $730.26	Professional		$265.69	$507.23	$730.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $111.44 / $162.10 / $275.56	Professional	26	$111.44	$162.10	$275.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.25 / $321.13 / $431.69	Professional	TC	$154.25	$321.13	$431.69
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $459.15 / $581.20 / $683.70	Professional		$459.15	$581.20	$683.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $157.05 / $198.80 / $233.90	Professional	26	$157.05	$198.80	$233.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $302.02 / $382.30 / $449.80	Professional	TC	$302.02	$382.30	$449.80