Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.87 / $38.65 / $71.56	Facility	26	$11.87	$38.65	$71.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $40.54 / $194.04	Professional		$35.67	$40.54	$194.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $11.35 / $26.38	Professional	26	$10.23	$11.35	$26.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.05 / $29.17 / $65.05	Professional	TC	$25.05	$29.17	$65.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.97 / $39.11 / $40.26	Facility	26	$37.97	$39.11	$40.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.23 / $101.62 / $127.02	Professional		$42.23	$101.62	$127.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.75 / $27.15 / $37.65	Professional	26	$12.75	$27.15	$37.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.23 / $74.47 / $93.08	Professional	TC	$28.23	$74.47	$93.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $38.18 / $58.84 / $102.97	Professional		$38.18	$58.84	$102.97
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $18.17 / $32.76	Professional	26	$11.22	$18.17	$32.76
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.96 / $40.59 / $66.73	Professional	TC	$26.96	$40.59	$66.73
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $39.11 / $100.00 / $100.00	Facility	26	$39.11	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.44 / $64.68 / $282.36	Professional		$39.44	$64.68	$282.36
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.45 / $16.21 / $90.81	Professional	26	$12.45	$16.21	$90.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.71 / $35.68 / $211.00	Professional	TC	$26.71	$35.68	$211.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $39.11 / $40.26 / $65.94	Facility	26	$39.11	$40.26	$65.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.00 / $85.20 / $128.27	Professional		$64.00	$85.20	$128.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.04 / $39.10 / $72.23	Professional		$12.04	$39.10	$72.23
United Facility/Professional Professional Modifier Low / Median / High Price $39.44 / $49.05 / $81.06	Professional		$39.44	$49.05	$81.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.45 / $15.67 / $27.37	Professional	26	$12.45	$15.67	$27.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.99 / $35.15 / $66.23	Professional	TC	$26.99	$35.15	$66.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $59.09 / $74.80 / $88.00	Professional		$59.09	$74.80	$88.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $16.27 / $20.60 / $24.20	Professional	26	$16.27	$20.60	$24.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $42.82 / $54.20 / $63.80	Professional	TC	$42.82	$54.20	$63.80