Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.21 / $26.21 / $79.78	Facility	26	$26.21	$26.21	$79.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.72 / $53.00 / $258.00	Professional		$44.72	$53.00	$258.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $14.81 / $37.11	Professional	26	$13.58	$14.81	$37.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.56 / $38.22 / $69.39	Professional	TC	$31.56	$38.22	$69.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.33 / $49.78 / $51.23	Facility	26	$48.33	$49.78	$51.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.93 / $122.56 / $153.19	Professional		$52.93	$122.56	$153.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.41 / $34.90 / $46.95	Professional	26	$16.41	$34.90	$46.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.52 / $87.65 / $109.57	Professional	TC	$36.52	$87.65	$109.57
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $45.85 / $77.25 / $138.13	Professional		$45.85	$77.25	$138.13
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.35 / $23.26 / $44.04	Professional	26	$14.35	$23.26	$44.04
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.50 / $50.02 / $93.24	Professional	TC	$31.50	$50.02	$93.24
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $49.78 / $100.00 / $100.00	Facility	26	$49.78	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.80 / $82.80 / $338.57	Professional		$49.80	$82.80	$338.57
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.96 / $20.78 / $117.24	Professional	26	$15.96	$20.78	$117.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.94 / $42.44 / $291.00	Professional	TC	$31.94	$42.44	$291.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $49.78 / $51.23 / $85.68	Facility	26	$49.78	$51.23	$85.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $84.69 / $106.20 / $177.02	Professional		$84.69	$106.20	$177.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.50 / $46.82 / $86.59	Professional		$15.50	$46.82	$86.59
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $59.83 / $96.29	Professional		$47.86	$59.83	$96.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.96 / $19.79 / $33.79	Professional	26	$15.96	$19.79	$33.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.90 / $40.65 / $68.43	Professional	TC	$31.90	$40.65	$68.43
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $70.78 / $89.60 / $105.50	Professional		$70.78	$89.60	$105.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $20.78 / $26.30 / $30.90	Professional	26	$20.78	$26.30	$30.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $50.09 / $63.40 / $74.59	Professional	TC	$50.09	$63.40	$74.59