Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $7.94 / $56.23	Facility	26	$7.94	$7.94	$56.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $20.42 / $97.72	Professional		$15.14	$20.42	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.18 / $53.70	Professional	26	$7.94	$13.18	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $6.03 / $7.94 / $22.39	Professional	TC	$6.03	$7.94	$22.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $33.88 / $34.67	Facility	26	$32.36	$33.88	$34.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $44.67 / $54.95	Professional		$26.30	$44.67	$54.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $22.91 / $28.84	Professional	26	$12.59	$22.91	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $21.38 / $27.54	Professional	TC	$12.30	$21.38	$27.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $37.15 / $141.25	Professional		$17.38	$37.15	$141.25
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.14 / $72.44	Professional	26	$9.33	$15.14	$72.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $7.76 / $15.14 / $79.43	Professional	TC	$7.76	$15.14	$79.43
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $33.88 / $100.00 / $100.00	Facility	26	$33.88	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $36.31 / $208.93	Professional		$20.42	$36.31	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $15.49 / $104.71	Professional	26	$10.23	$15.49	$104.71
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $8.51 / $13.80 / $128.82	Professional	TC	$8.51	$13.80	$128.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $42.66 / $54.95	Professional		$36.31	$42.66	$54.95
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $22.39 / $30.90	Professional	26	$19.50	$22.39	$30.90
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $20.89 / $27.54	Professional	TC	$16.22	$20.89	$27.54
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $34.67 / $34.67	Facility	26	$34.67	$34.67	$34.67
Midlands Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $44.67 / $50.12	Professional		$42.66	$44.67	$50.12
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $22.39 / $23.99	Professional	26	$21.38	$22.39	$23.99
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $20.89 / $27.54	Professional	TC	$18.20	$20.89	$27.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $17.78 / $33.88	Professional		$9.55	$17.78	$33.88
United Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $23.44 / $41.69	Professional		$18.20	$23.44	$41.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $12.88 / $22.91	Professional	26	$10.23	$12.88	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.13 / $11.48 / $19.50	Professional	TC	$8.13	$11.48	$19.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $38.02	Professional		$32.36	$32.36	$38.02
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $16.98 / $20.42	Professional	26	$16.98	$16.98	$20.42
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $15.49 / $18.20	Professional	TC	$15.49	$15.49	$18.20