Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.55 / $26.67 / $49.26	Facility	26	$11.55	$26.67	$49.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.45 / $31.24 / $151.88	Professional		$27.45	$31.24	$151.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.30 / $8.13 / $18.80	Professional	26	$7.30	$8.13	$18.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.16 / $23.09 / $44.96	Professional	TC	$20.16	$23.09	$44.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.97 / $26.75 / $27.53	Facility	26	$25.97	$26.75	$27.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.64 / $75.23 / $94.05	Professional		$32.64	$75.23	$94.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.89 / $18.62 / $25.77	Professional	26	$8.89	$18.62	$25.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.74 / $56.63 / $70.78	Professional	TC	$23.74	$56.63	$70.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $28.22 / $46.33 / $87.51	Professional		$28.22	$46.33	$87.51
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $12.72 / $22.07	Professional	26	$7.78	$12.72	$22.07
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.44 / $32.60 / $57.33	Professional	TC	$20.44	$32.60	$57.33
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $100.00 / $100.00	Facility	26	$26.75	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.83 / $49.65 / $208.83	Professional		$29.83	$49.65	$208.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.64 / $11.17 / $66.04	Professional	26	$8.64	$11.17	$66.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.12 / $26.86 / $188.00	Professional	TC	$20.12	$26.86	$188.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $27.53 / $46.62	Facility	26	$26.75	$27.53	$46.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $54.60 / $65.40 / $109.83	Professional		$54.60	$65.40	$109.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.50 / $28.83 / $54.46	Professional		$8.50	$28.83	$54.46
United Facility/Professional Professional Modifier Low / Median / High Price $28.70 / $37.36 / $61.56	Professional		$28.70	$37.36	$61.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.58 / $10.56 / $18.00	Professional	26	$8.58	$10.56	$18.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.12 / $25.16 / $43.55	Professional	TC	$20.12	$25.16	$43.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $43.77 / $55.40 / $65.20	Professional		$43.77	$55.40	$65.20
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 $32.47 / $41.10 / $48.40	Professional	TC	$32.47	$41.10	$48.40