Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.67 / $16.05 / $49.92	Facility	26	$8.67	$16.05	$49.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.86 / $32.22 / $154.00	Professional		$28.86	$32.22	$154.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.17 / $9.02 / $21.60	Professional	26	$8.17	$9.02	$21.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.23 / $23.11 / $45.18	Professional	TC	$20.23	$23.11	$45.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.24 / $31.15 / $32.04	Facility	26	$30.24	$31.15	$32.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.71 / $77.56 / $110.04	Professional		$33.71	$77.56	$110.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.97 / $20.94 / $30.00	Professional	26	$9.97	$20.94	$30.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.74 / $56.63 / $78.22	Professional	TC	$23.74	$56.63	$78.22
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $29.19 / $49.17 / $95.20	Professional		$29.19	$49.17	$95.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.75 / $14.22 / $30.19	Professional	26	$8.75	$14.22	$30.19
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.44 / $33.13 / $61.19	Professional	TC	$20.44	$33.13	$61.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $31.15 / $100.00 / $100.00	Facility	26	$31.15	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.54 / $53.00 / $217.42	Professional		$31.54	$53.00	$217.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.10 / $13.01 / $72.64	Professional	26	$10.10	$13.01	$72.64
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.70 / $27.28 / $199.00	Professional	TC	$20.70	$27.28	$199.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $31.15 / $32.04 / $52.50	Facility	26	$31.15	$32.04	$52.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $56.28 / $65.59 / $113.23	Professional		$56.28	$65.59	$113.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $44.50 / $44.50 / $89.50	Professional		$44.50	$44.50	$89.50
United Facility/Professional Professional Modifier Low / Median / High Price $31.23 / $37.90 / $62.88	Professional		$31.23	$37.90	$62.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.99 / $12.39 / $20.96	Professional	26	$9.99	$12.39	$20.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.45 / $26.63 / $44.70	Professional	TC	$20.45	$26.63	$44.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $45.11 / $57.10 / $67.20	Professional		$45.11	$57.10	$67.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $12.64 / $16.00 / $18.80	Professional	26	$12.64	$16.00	$18.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $32.47 / $41.10 / $48.40	Professional	TC	$32.47	$41.10	$48.40