Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.93 / $31.91 / $59.09	Facility	26	$17.93	$31.91	$59.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.45 / $30.43 / $75.69	Professional		$27.45	$30.43	$75.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.47 / $9.27 / $21.32	Professional	26	$8.47	$9.27	$21.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.98 / $21.35 / $39.10	Professional	TC	$18.98	$21.35	$39.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.31 / $32.25 / $33.19	Facility	26	$31.31	$32.25	$33.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $74.47 / $93.08	Professional		$32.36	$74.47	$93.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.10 / $21.72 / $28.04	Professional	26	$10.10	$21.72	$28.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.11 / $52.75 / $65.93	Professional	TC	$22.11	$52.75	$65.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $28.01 / $47.17 / $104.23	Professional		$28.01	$47.17	$104.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.99 / $13.98 / $35.22	Professional	26	$8.99	$13.98	$35.22
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.02 / $31.67 / $64.15	Professional	TC	$19.02	$31.67	$64.15
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $32.25 / $100.00 / $100.00	Facility	26	$32.25	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.17 / $51.00 / $206.60	Professional		$30.17	$51.00	$206.60
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.96 / $12.97 / $78.44	Professional	26	$9.96	$12.97	$78.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.13 / $25.55 / $193.00	Professional	TC	$19.13	$25.55	$193.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $32.25 / $33.19 / $52.32	Facility	26	$32.25	$33.19	$52.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $65.40 / $108.68	Professional		$55.00	$65.40	$108.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.80 / $42.80 / $85.70	Professional		$42.80	$42.80	$85.70
United Facility/Professional Professional Modifier Low / Median / High Price $29.09 / $34.90 / $59.64	Professional		$29.09	$34.90	$59.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.94 / $12.45 / $20.87	Professional	26	$9.94	$12.45	$20.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.13 / $23.77 / $38.96	Professional	TC	$19.13	$23.77	$38.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $43.29 / $54.80 / $64.50	Professional		$43.29	$54.80	$64.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.11 / $16.60 / $19.50	Professional	26	$13.11	$16.60	$19.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $30.26 / $38.29 / $45.00	Professional	TC	$30.26	$38.29	$45.00