Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $107.15	Professional		$87.10	$87.10	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $23.44 / $28.84	Professional	26	$23.44	$23.44	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $63.10 / $79.43	Professional	TC	$63.10	$63.10	$79.43
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $100.00 / $194.98	Professional		$67.61	$100.00	$194.98
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $20.89 / $194.98	Professional	26	$19.05	$20.89	$194.98
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $54.95 / $194.98	Professional	TC	$48.98	$54.95	$194.98
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $104.71 / $104.71	Facility	26	$104.71	$104.71	$104.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $117.49 / $269.15	Professional		$81.28	$117.49	$269.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.30 / $74.13	Professional	26	$19.95	$26.30	$74.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $81.28 / $338.84	Professional	TC	$54.95	$81.28	$338.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $131.83 / $275.42	Professional		$93.33	$131.83	$275.42
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $36.31 / $79.43	Professional	26	$26.30	$36.31	$79.43
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $97.72 / $199.53	Professional	TC	$67.61	$97.72	$199.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $194.98	Professional		$120.23	$120.23	$194.98
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $33.11 / $53.70	Professional	26	$33.11	$33.11	$53.70
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $87.10 / $144.54	Professional	TC	$87.10	$87.10	$144.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $56.23 / $123.03	Professional		$20.89	$56.23	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $104.71 / $177.83	Professional		$77.62	$104.71	$177.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $26.30 / $45.71	Professional	26	$21.38	$26.30	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $75.86 / $141.25	Professional	TC	$54.95	$75.86	$141.25