Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $16.22 / $17.78	Facility	26	$7.08	$16.22	$17.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $33.88 / $162.18	Professional		$25.12	$33.88	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $8.71 / $20.89	Professional	26	$7.08	$8.71	$20.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $24.55 / $87.10	Professional	TC	$18.20	$24.55	$87.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $26.92 / $27.54	Facility	26	$25.70	$26.92	$27.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $77.62 / $95.50	Professional		$39.81	$77.62	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $19.05 / $23.99	Professional	26	$10.72	$19.05	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $57.54 / $72.44	Professional	TC	$28.84	$57.54	$72.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $47.86 / $100.00	Professional		$28.84	$47.86	$100.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.88 / $26.30	Professional	26	$7.76	$12.88	$26.30
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $33.11 / $77.62	Professional	TC	$21.38	$33.11	$77.62
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $100.00 / $100.00	Facility	26	$26.92	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $54.95 / $208.93	Professional		$29.51	$54.95	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.88 / $66.07	Professional	26	$8.71	$12.88	$66.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.20 / $186.21	Professional	TC	$19.95	$30.20	$186.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $69.18 / $87.10	Professional		$63.10	$69.18	$87.10
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $19.50 / $25.70	Professional	26	$16.98	$19.50	$25.70
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $51.29 / $60.26	Professional	TC	$45.71	$51.29	$60.26
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $27.54 / $27.54	Facility	26	$27.54	$27.54	$27.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $63.10 / $81.28	Professional		$57.54	$63.10	$81.28
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $19.50 / $25.12	Professional	26	$16.60	$19.50	$25.12
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $45.71 / $60.26	Professional	TC	$39.81	$45.71	$60.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $25.12 / $54.95	Professional		$8.71	$25.12	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $36.31 / $66.07	Professional		$28.84	$36.31	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.72 / $19.50	Professional	26	$8.51	$10.72	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $26.30 / $47.86	Professional	TC	$19.95	$26.30	$47.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $64.57	Professional		$54.95	$54.95	$64.57
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $14.45 / $16.98	Professional	26	$14.45	$14.45	$16.98
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $40.74 / $47.86	Professional	TC	$40.74	$40.74	$47.86