Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.70 / $14.25 / $42.83	Facility	26	$7.70	$14.25	$42.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.37 / $35.92 / $165.08	Professional		$30.37	$35.92	$165.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.23 / $30.60	Professional	26	$7.33	$8.23	$30.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $27.03 / $62.27	Professional	TC	$22.57	$27.03	$62.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.00 / $26.78 / $27.56	Facility	26	$26.00	$26.78	$27.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.29 / $87.65 / $109.57	Professional		$33.29	$87.65	$109.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.89 / $18.62 / $25.89	Professional	26	$8.89	$18.62	$25.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.32 / $69.04 / $86.30	Professional	TC	$23.32	$69.04	$86.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $32.76 / $49.08 / $85.39	Professional		$32.76	$49.08	$85.39
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $12.72 / $23.04	Professional	26	$7.78	$12.72	$23.04
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.98 / $37.58 / $59.25	Professional	TC	$24.98	$37.58	$59.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.78 / $100.00 / $100.00	Facility	26	$26.78	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.61 / $54.78 / $245.68	Professional		$33.61	$54.78	$245.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.64 / $11.18 / $61.09	Professional	26	$8.64	$11.18	$61.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.78 / $33.08 / $192.57	Professional	TC	$23.78	$33.08	$192.57
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $26.78 / $27.56 / $44.82	Facility	26	$26.78	$27.56	$44.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $73.12 / $100.05	Professional		$50.00	$73.12	$100.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.50 / $33.54 / $62.62	Professional		$8.50	$33.54	$62.62
United Facility/Professional Professional Modifier Low / Median / High Price $33.61 / $42.01 / $67.62	Professional		$33.61	$42.01	$67.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.58 / $10.79 / $18.00	Professional	26	$8.58	$10.79	$18.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.05 / $31.04 / $51.00	Professional	TC	$24.05	$31.04	$51.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $50.96 / $64.50 / $75.90	Professional		$50.96	$64.50	$75.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $11.30 / $14.30 / $16.80	Professional	26	$11.30	$14.30	$16.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $39.65 / $50.20 / $59.10	Professional	TC	$39.65	$50.20	$59.10