Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.75 / $27.79 / $51.34	Facility	26	$8.75	$27.79	$51.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.87 / $34.61 / $69.62	Professional		$29.87	$34.61	$69.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $8.43 / $20.30	Professional	26	$7.59	$8.43	$20.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.94 / $25.79 / $43.21	Professional	TC	$21.94	$25.79	$43.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.24 / $28.06 / $28.87	Facility	26	$27.24	$28.06	$28.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.69 / $89.98 / $112.48	Professional		$33.69	$89.98	$112.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.25 / $19.39 / $27.59	Professional	26	$9.25	$19.39	$27.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.32 / $69.28 / $88.24	Professional	TC	$23.32	$69.28	$88.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $33.65 / $50.42 / $79.11	Professional		$33.65	$50.42	$79.11
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.10 / $13.25 / $23.99	Professional	26	$8.10	$13.25	$23.99
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.54 / $37.25 / $54.51	Professional	TC	$25.54	$37.25	$54.51
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $28.06 / $100.00 / $100.00	Facility	26	$28.06	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.97 / $55.00 / $293.00	Professional		$33.97	$55.00	$293.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $11.65 / $55.28	Professional	26	$9.02	$11.65	$55.28
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.78 / $33.07 / $283.00	Professional	TC	$23.78	$33.07	$283.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $28.06 / $28.87 / $48.60	Facility	26	$28.06	$28.87	$48.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $75.75 / $101.35	Professional		$50.00	$75.75	$101.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.97 / $34.47 / $67.58	Professional		$8.97	$34.47	$67.58
United Facility/Professional Professional Modifier Low / Median / High Price $32.54 / $42.23 / $68.34	Professional		$32.54	$42.23	$68.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.94 / $11.18 / $18.76	Professional	26	$8.94	$11.18	$18.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.96 / $32.59 / $50.98	Professional	TC	$24.96	$32.59	$50.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $52.30 / $66.20 / $77.90	Professional		$52.30	$66.20	$77.90
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 $40.61 / $51.40 / $60.50	Professional	TC	$40.61	$51.40	$60.50