Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.54 / $21.27 / $65.66	Facility	26	$12.54	$21.27	$65.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.77 / $44.53 / $202.00	Professional		$38.77	$44.53	$202.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.10 / $12.03 / $30.54	Professional	26	$11.10	$12.03	$30.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.55 / $31.96 / $71.98	Professional	TC	$27.55	$31.96	$71.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.18 / $39.33 / $40.47	Facility	26	$38.18	$39.33	$40.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.00 / $109.37 / $136.72	Professional		$47.00	$109.37	$136.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.11 / $27.93 / $38.54	Professional	26	$13.11	$27.93	$38.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.90 / $81.28 / $101.81	Professional	TC	$33.90	$81.28	$101.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $40.77 / $64.80 / $125.58	Professional		$40.77	$64.80	$125.58
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.54 / $18.64 / $36.49	Professional	26	$11.54	$18.64	$36.49
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.23 / $45.81 / $81.45	Professional	TC	$29.23	$45.81	$81.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $39.33 / $100.00 / $100.00	Facility	26	$39.33	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.75 / $72.43 / $306.22	Professional		$42.75	$72.43	$306.22
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.14 / $17.11 / $95.76	Professional	26	$13.14	$17.11	$95.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.61 / $39.13 / $250.00	Professional	TC	$29.61	$39.13	$250.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $39.33 / $40.47 / $69.72	Facility	26	$39.33	$40.47	$69.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $73.00 / $92.32 / $151.37	Professional		$73.00	$92.32	$151.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $62.50 / $62.50 / $120.80	Professional		$62.50	$62.50	$120.80
United Facility/Professional Professional Modifier Low / Median / High Price $42.75 / $55.67 / $86.01	Professional		$42.75	$55.67	$86.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.14 / $16.11 / $27.55	Professional	26	$13.14	$16.11	$27.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.45 / $36.69 / $60.33	Professional	TC	$29.45	$36.69	$60.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $63.12 / $79.90 / $94.00	Professional		$63.12	$79.90	$94.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $16.67 / $21.10 / $24.90	Professional	26	$16.67	$21.10	$24.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $46.45 / $58.80 / $69.20	Professional	TC	$46.45	$58.80	$69.20