Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.02 / $14.85 / $41.22	Facility	26	$8.02	$14.85	$41.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.26 / $30.12 / $135.40	Professional		$25.26	$30.12	$135.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $8.56 / $37.19	Professional	26	$7.59	$8.56	$37.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $20.71 / $51.18	Professional	TC	$17.57	$20.71	$51.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.95 / $26.73 / $27.51	Facility	26	$25.95	$26.73	$27.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.08 / $72.92 / $91.14	Professional		$29.08	$72.92	$91.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.25 / $19.39 / $25.48	Professional	26	$9.25	$19.39	$25.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.10 / $53.52 / $66.90	Professional	TC	$19.10	$53.52	$66.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $27.41 / $40.90 / $79.11	Professional		$27.41	$40.90	$79.11
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.10 / $12.85 / $24.22	Professional	26	$8.10	$12.85	$24.22
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.30 / $29.00 / $45.13	Professional	TC	$19.30	$29.00	$45.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $63.44 / $100.00 / $100.00	Facility	26	$63.44	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.41 / $46.31 / $202.27	Professional		$28.41	$46.31	$202.27
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.94 / $11.65 / $111.75	Professional	26	$8.94	$11.65	$111.75
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.76 / $25.99 / $146.99	Professional	TC	$18.76	$25.99	$146.99
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $26.73 / $27.51 / $48.60	Facility	26	$26.73	$27.51	$48.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $41.23 / $60.96 / $87.24	Professional		$41.23	$60.96	$87.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.90 / $41.90 / $76.30	Professional		$41.90	$41.90	$76.30
United Facility/Professional Professional Modifier Low / Median / High Price $28.41 / $34.09 / $59.06	Professional		$28.41	$34.09	$59.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.94 / $11.18 / $17.98	Professional	26	$8.94	$11.18	$17.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.47 / $23.77 / $42.24	Professional	TC	$19.47	$23.77	$42.24
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $42.42 / $53.70 / $63.10	Professional		$42.42	$53.70	$63.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $11.69 / $14.80 / $17.50	Professional	26	$11.69	$14.80	$17.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $30.65 / $38.79 / $45.70	Professional	TC	$30.65	$38.79	$45.70