Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.36 / $38.65 / $71.56	Facility	26	$9.36	$38.65	$71.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.13 / $38.92 / $184.33	Professional		$32.13	$38.92	$184.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.05 / $10.64 / $26.38	Professional	26	$9.05	$10.64	$26.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.08 / $27.69 / $60.32	Professional	TC	$23.08	$27.69	$60.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.00 / $39.14 / $40.28	Facility	26	$38.00	$39.14	$40.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.08 / $87.65 / $123.20	Professional		$38.08	$87.65	$123.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $24.00 / $35.25	Professional	26	$11.07	$24.00	$35.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.02 / $64.38 / $87.95	Professional	TC	$27.02	$64.38	$87.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $32.95 / $56.88 / $114.83	Professional		$32.95	$56.88	$114.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.68 / $17.21 / $33.14	Professional	26	$9.68	$17.21	$33.14
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.27 / $39.72 / $72.39	Professional	TC	$23.27	$39.72	$72.39
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $39.14 / $100.00 / $100.00	Facility	26	$39.14	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.18 / $64.00 / $262.00	Professional		$37.18	$64.00	$262.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.55 / $14.46 / $107.32	Professional	26	$11.55	$14.46	$107.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.33 / $31.14 / $249.00	Professional	TC	$24.33	$31.14	$249.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $39.14 / $40.28 / $58.26	Facility	26	$39.14	$40.28	$58.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $70.31 / $80.41 / $127.93	Professional		$70.31	$80.41	$127.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.38 / $33.70 / $63.37	Professional		$10.38	$33.70	$63.37
United Facility/Professional Professional Modifier Low / Median / High Price $34.11 / $44.42 / $111.27	Professional		$34.11	$44.42	$111.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.04 / $13.71 / $23.39	Professional	26	$11.04	$13.71	$23.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.22 / $30.04 / $56.59	Professional	TC	$24.22	$30.04	$56.59
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 $13.98 / $17.70 / $20.80	Professional	26	$13.98	$17.70	$20.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $36.97 / $46.80 / $55.10	Professional	TC	$36.97	$46.80	$55.10