Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.88 / $33.60 / $61.92	Facility	26	$19.88	$33.60	$61.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.70 / $18.59 / $32.14	Professional		$15.70	$18.59	$32.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.74 / $9.53 / $50.17	Professional	26	$8.74	$9.53	$50.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $6.90 / $8.22 / $12.62	Professional	TC	$6.90	$8.22	$12.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.54 / $33.53 / $34.50	Facility	26	$32.54	$33.53	$34.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.06 / $43.44 / $54.55	Professional		$22.06	$43.44	$54.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.62 / $22.50 / $31.26	Professional	26	$10.62	$22.50	$31.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.28 / $20.94 / $27.05	Professional	TC	$10.28	$20.94	$27.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $30.95 / $138.80	Professional		$16.98	$30.95	$138.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.32 / $15.04 / $59.14	Professional	26	$9.32	$15.04	$59.14
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $7.67 / $14.17 / $64.89	Professional	TC	$7.67	$14.17	$64.89
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $33.53 / $100.00 / $100.00	Facility	26	$33.53	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $19.80 / $34.74 / $206.87	Professional		$19.80	$34.74	$206.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.32 / $13.44 / $105.66	Professional	26	$10.32	$13.44	$105.66
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $8.44 / $12.52 / $129.58	Professional	TC	$8.44	$12.52	$129.58
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $33.53 / $34.50 / $54.30	Facility	26	$33.53	$34.50	$54.30
Midlands Facility/Professional Professional Modifier Low / Median / High Price $34.32 / $41.03 / $64.54	Professional		$34.32	$41.03	$64.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.97 / $17.05 / $33.38	Professional		$8.97	$17.05	$33.38
United Facility/Professional Professional Modifier Low / Median / High Price $18.00 / $23.44 / $38.75	Professional		$18.00	$23.44	$38.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.32 / $13.00 / $21.88	Professional	26	$10.32	$13.00	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.23 / $10.00 / $17.51	Professional	TC	$8.23	$10.00	$17.51
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $25.68 / $32.50 / $38.29	Professional		$25.68	$32.50	$38.29
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.51 / $17.10 / $20.20	Professional	26	$13.51	$17.10	$20.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $12.17 / $15.40 / $18.10	Professional	TC	$12.17	$15.40	$18.10