Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.82 / $14.85 / $41.22	Facility	26	$7.82	$14.85	$41.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.85 / $30.81 / $142.01	Professional		$25.85	$30.81	$142.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.34 / $18.57	Professional	26	$7.33	$8.34	$18.57
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.23 / $16.23 / $59.24	Professional	50	$16.23	$16.23	$59.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $21.80 / $43.94	Professional	TC	$18.53	$21.80	$43.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.80 / $26.57 / $27.35	Facility	26	$25.80	$26.57	$27.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.08 / $76.79 / $95.99	Professional		$29.08	$76.79	$95.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.25 / $19.39 / $26.21	Professional	26	$9.25	$19.39	$26.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.10 / $56.44 / $71.75	Professional	TC	$19.10	$56.44	$71.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $28.82 / $43.07 / $100.46	Professional		$28.82	$43.07	$100.46
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.10 / $12.85 / $27.68	Professional	26	$8.10	$12.85	$27.68
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.72 / $31.15 / $63.79	Professional	TC	$20.72	$31.15	$63.79
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.57 / $100.00 / $100.00	Facility	26	$26.57	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.70 / $47.07 / $208.77	Professional		$28.70	$47.07	$208.77
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.53 / $10.74 / $82.56	Professional	26	$8.53	$10.74	$82.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.43 / $27.01 / $153.47	Professional	TC	$19.43	$27.01	$153.47
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $26.57 / $27.35 / $46.80	Facility	26	$26.57	$27.35	$46.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $41.23 / $63.52 / $87.24	Professional		$41.23	$63.52	$87.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.83 / $29.45 / $55.05	Professional		$8.83	$29.45	$55.05
United Facility/Professional Professional Modifier Low / Median / High Price $28.70 / $37.02 / $60.90	Professional		$28.70	$37.02	$60.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.25 / $10.74 / $19.76	Professional	26	$8.25	$10.74	$19.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $26.63 / $41.64	Professional	TC	$20.42	$26.63	$41.64
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $44.64 / $56.50 / $66.50	Professional		$44.64	$56.50	$66.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $11.69 / $14.80 / $17.50	Professional	26	$11.69	$14.80	$17.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $32.94 / $41.70 / $49.00	Professional	TC	$32.94	$41.70	$49.00